Fully Integrating Medicaid & Medicare Benefits May Not Reduce Service Utilization

Plans designed specifically to integrate care for disabled dual-eligible Medicare and Medicaid beneficiaries are not necessarily enough to reduce beneficiaries’ use of costly services, according to an analysis of data by the Government Accountability Office (GAO). Disabled dual eligibles are under age 65 and qualify for Medicare due to their disability status and meet Medicaid income eligibility criteria. Of the approximately nine million dual eligibles, about four million are disabled dual eligibles. Of the four million disabled duals, about 12% are enrolled in a Medicare Advantage plan, most are enrolled in a specialized special needs plan for dual eligibles . . .