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Improving Health Care Quality

The Health Care Experiences of People Dually Eligible for Medicare and Medicaid

Comparing Traditional Medicare and Medicare Advantage
Elderly woman with walker is helped by a in-home nurse.

Vivian Goldman, 84, is helped by her certified health care nurse, Elaine James, 73, of Visiting Angels, at her family’s home in District Heights, Md. In addition to having low income and few resources, beneficiaries dually eligible for Medicaid and Medicare typically have more complex health care needs than the average Medicare enrollee. Photo: Amanda Voisard/Washington Post via Getty Images

Vivian Goldman, 84, is helped by her certified health care nurse, Elaine James, 73, of Visiting Angels, at her family’s home in District Heights, Md. In addition to having low income and few resources, beneficiaries dually eligible for Medicaid and Medicare typically have more complex health care needs than the average Medicare enrollee. Photo: Amanda Voisard/Washington Post via Getty Images

Toplines

  • The number of Americans enrolled in both Medicare and Medicaid is increasing, and a growing share are covered by a private Medicare Advantage plan

  • Whether enrolled in traditional Medicare or Medicare Advantage, dual-eligible beneficiaries’ coverage and care experiences are largely similar

Toplines

  • The number of Americans enrolled in both Medicare and Medicaid is increasing, and a growing share are covered by a private Medicare Advantage plan

  • Whether enrolled in traditional Medicare or Medicare Advantage, dual-eligible beneficiaries’ coverage and care experiences are largely similar

Authors
Janet P. Sutton, Gretchen Jacobson, Faith Leonard
RELATED CONTENT

People enrolled in both Medicare and Medicaid coverage are known as dual-eligible beneficiaries. They qualify for Medicare because they're at least 65 years old or because they're under age 65 and have a qualifying disability or medical condition. They qualify for Medicaid because they have low income and few resources.

In 2024, about 12.8 million Americans are dual-eligible beneficiaries. Typically, they have more complex health care needs than the average Medicare enrollee. The charts that follow compare the health care experiences of dual-eligible beneficiaries enrolled in the traditional Medicare program with those in Medicare Advantage, which provides Medicare benefits through private insurance plans.

Key Findings

  • From 2016 to 2022, the number of dual-eligible beneficiaries increased from 10 million to 12 million.
  • A larger share of dual-eligible beneficiaries are enrolled in Medicare Advantage plans than in traditional Medicare. From 2013 to 2021, the proportion of dual-eligible beneficiaries in these plans doubled, from 24 percent to 51 percent.
  • Ratings of satisfaction and ease of getting health care were similar, on average, for dual-eligible beneficiaries in Medicare Advantage plans and those in traditional Medicare.
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DATA AND METHODS

We estimated the number of dual-eligible beneficiaries and enrollment in Medicare Advantage plans based on data obtained from the Centers for Medicare and Medicaid Services’ enrollment files and reports. Information on the characteristics of dual-eligible beneficiaries and their health care experiences (for example, access to care, barriers to care, and satisfaction with care) came from the 2020 Medicare Current Beneficiary Survey.

We conducted descriptive analyses, consisting primarily of frequencies and cross-tabs, and applied sampling weights to produce estimates generalizable to the larger Medicare population.

Finally, we examined descriptive statistics (chi-square analysis and t-tests) to determine whether differences observed among beneficiaries in traditional Medicare and Medicare Advantage were statistically significant at the p<.05 level.

Publication Details

Date

Contact

Janet P. Sutton, Senior Policy Associate, Acumen LLC

[email protected]

Citation

Janet P. Sutton, Gretchen Jacobson, and Faith Leonard, “The Health Care Experiences of People Dually Eligible for Medicare and Medicaid: Comparing Traditional Medicare and Medicare Advantage,” chartpack, Commonwealth Fund, June 27, 2024. https://doi.org/10.26099/48jr-7755

Area of Focus

Topics

Medicare,
Fee for Service Medicare,
Medicare Advantage,
Medicaid,
Quality of Care

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