MedPAC, MACPAC Release Data on Beneficiaries Dually Eligible for Medicare and Medicaid

January 29, 2024

The Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment and Access Commission (MACPAC) recently released a data book on beneficiaries dually eligible for Medicare and Medicaid. The data book includes statistics on the characteristics of dual-eligible beneficiaries, enrollment, utilization, and spending.

The groups reported that in 2021, individuals enrolled in fee-for-service (FFS) Medicare who were dually eligible for Medicaid had a higher use of Medicare inpatient hospital services than their non-dual Medicare beneficiary counterparts (22% vs. 13%). Additionally, per-user Medicare FFS spending was higher for dual-eligible beneficiaries ($27,207 vs. $22,092).

The number of dual-eligible beneficiaries increased by 2% nationally between 2018 and 2021. New York experienced a 2.6% increase while Connecticut, New Jersey, and Rhode Island had increases of 2.2%, 1.4%, and 1.3%, respectively.

The report also highlighted the shift away from FFS Medicare and FFS Medicaid towards managed care enrollment. The share of dual-eligible beneficiaries who were enrolled in FFS Medicare and FFS Medicaid declined between 2018 and 2021 by 14 and 4.9 percentage points, respectively. Conversely, the share of dual-eligible beneficiaries whose only Medicare enrollment was in Medicare Advantage increased by 12.9 percentage points, and the share of dual-eligible beneficiaries with at least one month of comprehensive Medicaid managed care enrollment increased by 7.5 percentage points over the same period.