Part D and health care utilization and cost of Medicaid/Medicare dual eligibles

Objectives:

To explore the relationship between dual eligibility and health care utilization and cost among Medicare beneficiaries, before and after the enactment of the Medicare Part D drug benefit. To further explore a subgroup of particular interest for Michigan Department of Community Health, the dual eligibles in long term care. These analyses will provide evidence on the impact of the Medicare Modernization Act of 2003 on health care utilization and cost.

Materials and Methods:

This research study will use individual level matched Medicaid and Medicare medical claims and stay records in a statewide population. Medicare and Medicaid data come from CMS and Michigan Department of Community Health (MDCH) data warehouse. The MDCH data warehouse integrates multiple data sources on Medicaid beneficiaries, including medical claims and Vital Records. The Medicare data contain individual medical claims, stay records, and detailed Medicare eligibility. Cross-section and longitudinal comparisons of health care use outcomes and costs will be made between dual eligibles and Medicare-only beneficiaries, and between care settings among long-term care beneficiaries.

Results:

We have no results to share yet, except to say that there are around 200,000 dually eligible beneficiaries in Michigan.

Relevance:

Medicare Part D has special importance to dual eligibles because it replaces Medicaid as the payer for prescription drugs. Few studies looked at the changes brought by the enactment of Part D among dual eligibles. In addition, the setting and programs through which an individual receives care are an important determinant of the payment source.