Trends in medicare fee-for-service spending growth for dual-eligible beneficiaries, 2007-15

Laura M. Keohane, David G. Stevenson, Salama Freed, Sunita Thapa, Lucas Stewart, Melinda B. Buntin

Research output: Contribution to journalArticlepeer-review


Cost containment for dual-eligible beneficiaries (those enrolled in Medicare and Medicaid) is a key policy goal, but few studies have examined spending trends for this population.We contrasted growth in Medicare fee-for-service per beneficiary spending for those with and without Medicaid in the period 2007-15. Relative to Medicare-only enrollees, dual-eligible beneficiaries consistently had higher overall Medicare spending levels; however, they experienced steeper declines in spending growth over the study period. These trends varied across populations of interest. For instance, dual-eligible beneficiaries ages sixty-five and older went from having annual spending growth rates that were 1.8 percentage points higher than Medicare-only beneficiaries in 2008 to rates that were 1.1 percentage points lower in 2015. Across population groups, long-term users of nursing home care had some of the highest spending growth rates, averaging 1.7-4.1 percent annually depending on age group and Medicaid participation. These findings have implications for value-based payment and other Medicare policies aimed at controlling spending for dual-eligible beneficiaries.

Original languageEnglish (US)
Pages (from-to)1265-1273
Number of pages9
JournalHealth Affairs
Issue number8
StatePublished - Aug 1 2018
Externally publishedYes

ASJC Scopus subject areas

  • Health Policy


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