Dual eligibles have higher healthcare utilization, costs

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Dual-need seniors--those simultaneously enrolled in Medicare and Medicaid programs--use significantly more services than those enrolled in other programs, according to the Kaiser Family Foundation.

Altogether, about 9 million Americans are simultaneously enrolled in Medicare and Medicaid, enough of a population to create some vexing financial problems for the hospitals and other providers that care for them.

The Kaiser issue brief concluded that most dual-eligibles have more chronic conditions than the general Medicare population. In total, 55 percent of the dual-eligibles have three or more chronic conditions, compared to 44 percent of Medicare enrollees. Twenty-six percent have had at least one inpatient stay, compared to 18 percent of the Medicare population. Half report themselves to be in fair or poor health, compared to 22 percent of the Medicare population. And a dual eligible is 13 times more likely to be a resident of a long-term care facility.

According to the report, 24 states have some form of cost-containment measures for their dual-eligible population. However, providers have been more resistant to cost-cutting measures that impact dual-eligibles, reported American Medical News.

"The future health of our elderly, of our uninsured and Medicaid population ... (is) seriously at stake," Texas ophthalmologist Victor Gonzalez told amednews.

For more information:
- here's the Kaiser Family Foundation issue brief
- read the amednews article

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