Utilization of Home Healthcare Service By Medicare-Medicaid Dual Eligibles

Abstract

This study explores the characteristics of Medicare-only beneficiaries and Medicare-Medicaid dual eligibles in comparison, assess what factors determine the dual eligibility status, and examine the association between dual eligibility status and home healthcare service use. Using retrospective observational study of the U.S. 1996-2000 Medical Expenditure Panel Survey, we find that dual eligibles are disadvantaged in various personal characteristics compared to Medicare-only beneficiaries. The major predictors of dual eligibility status are race/ethnicity, family income and health conditions. Dual eligibles are likely to use more of both paid and unpaid home healthcare service, and subsequently induce higher total expenditures on home healthcare. As dual eligible population may be one contributor to the rapid growth in utilization and spending on home healthcare service in Medicare and Medicaid programs, policy makers need to precisely assess the medical need among the beneficiaries to efficiently coordinate Medicare and Medicaid programs.