Trends in Medicare Spending: an Analysis on the Dual-Eligible Population

The project team will build on prior Commonwealth Fund–supported work showing that most of the recent slowdown in Medicare spending is concentrated among the costliest 25 percent of beneficiaries. Melinda Buntin and her team will examine factors, such as use of institutional long-term care, that drove per-beneficiary spending by dual eligibles from 2007 to 2014. They will examine these results for key subsets of the dual-eligible population, including beneficiaries only partially covered by Medicaid or those residing in nursing homes. In addition, the researchers will analyze how changes in the characteristics of duals across states influence spending trends, and whether these trends change when states see disproportionate growth in their dual-eligible population relative to growth in their low-income elderly population.

Results from these analyses will begin to address the critical question of how reforms to Medicare reimbursement policies might affect states differently depending on the composition and needs of their dual-eligible populations. This work will contribute to policymakers’ understanding of the extent to which Medicare payments should adjust for the unique needs of these beneficiaries.