Dual Eligible Medicare Medicaid Enrollees Are 13 Percent Of The Combine Population But Account For 34 Percent Of Total Spending

Posted by Milton Recht:

From CBO, "Dual-Eligible Beneficiaries of Medicare and Medicaid: Characteristics, Health Care Spending, and Evolving Policies" June 6, 2013:

In 2009, the federal and state governments spent a total of more than $250 billion on health care benefits for the 9 million low-income elderly or disabled people who are jointly enrolled in Medicare and Medicaid.
***What Characteristics and Spending Patterns Distinguish the Dual-Eligible Population?
Dual-eligible beneficiaries are a varied group, but many have extensive health care needs, stemming from multiple illnesses and disabilities. In the case of full duals, for example, half initially qualified for Medicare because of disability rather than age, and nearly one-fifth have three or more chronic conditions (see figure below). Consequently, a sizable share of full duals, more than 40 percent, use long-term services and supports—a far greater percentage than for other Medicare or Medicaid beneficiaries.

Source: CBO

Although some full duals are fairly healthy and have relatively low health care costs, full duals as a group account for a disproportionate share of federal and state spending for Medicare and Medicaid. Full duals make up 13 percent of the combined population of Medicare enrollees and aged, blind, or disabled Medicaid enrollees (the categories of Medicaid participants who might also qualify for Medicare), but they account for 34 percent of the two programs’ total spending on those enrollees.