A Profile of Medicare-Medicaid Dual Beneficiaries
The approximately 12 million “dual beneficiaries” enrolled in both Medicare and Medicaid comprise a medically, functionally, and socially complex population. These individuals are often forced to navigate two uncoordinated systems and, as a result, they tend to experience poor health outcomes and barriers to access, resulting in high spending across both programs.
With support from Arnold Ventures, ATI Advisory quantified and described the demographics, delivery system access, health characteristics, social determinants of health, living environment, use of caregivers, Medicare utilization, and Medicare spending of individuals dually eligible for Medicare and Medicaid. We analyzed the Medicare Current Beneficiary Survey (MCBS) and other data sources to explore differences between beneficiaries with partial dual eligibility, full dual eligibility, and Medicare-only (non-dual), and to highlight considerations for policymakers as they seek to promote integration between Medicare and Medicaid.
Individuals who are dually eligible for Medicare and Medicaid experience greater and more complex health, functional, and social needs when compared to Medicare-only beneficiaries. Dual eligible beneficiaries particularly stand to benefit from equitable access to person-centered care. Impactful policymaking requires an understanding of the lived experiences of the individuals affected. The nuances in this chartbook support policymakers in their efforts to ensure that meaningfully integrated programs are available to all dual eligible beneficiaries regardless where they live.