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Dual Eligible Beneficiaries Receive Better Access to Care and Cost Protections when Enrolled in Medicare Advantage


Those enrolled in Medicare and Medicaid, called “dual eligibles,” have the highest spending and most complex medical, functional, and social needs of the Medicare population. These needs are exacerbated by the fragmentation in healthcare created by two insurance programs that were not designed to work together. Health plans, providers, and policymakers continue to explore ways to improve dual eligibles’ experiences and the Medicare Advantage (MA) program is at the center of much of this focus. With this context, it is important to understand how Medicare Advantage plans are serving this population.


This analysis is the fourth in a series of data briefs prepared by ATI Advisory for Better Medicare Alliance (BMA) during 2021, using the 2018 Medicare Current Beneficiary Survey (MCBS). This brief examined how Medicare coverage arrangements relate to demographics, outcomes, and spending in the dual eligible population.


Dual eligible beneficiaries, who are low-income and more likely to be a member of a racial minority group, face high rates of chronic conditions and social needs such as food insecurity and lack of transportation. This analysis builds on previous research that dual eligible beneficiaries are more likely to enroll in Medicare Advantage and finds that Medicare Advantage outperformed Fee-for-Service (FFS) Medicare in access to care and cost protections. 


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