Medicaid Utilization & Spending Among North Carolina Dual Eligibles Varies By Subgroup

Among North Carolina Medicaid beneficiaries also enrolled in Medicare (dual eligibles), their utilization of Medicaid services and spending varied across four need-based subgroups (community well, home- and community-based services, intensive behavioral health, and nursing home residents). For all dual eligibles, combined Medicare and Medicaid spending was $26,874 per person year (PPY), and overall, the funding of care was split evenly between Medicare and Medicaid.

Across the four need-based subgroups, combined spending was lowest among community well and highest among nursing home residents. Additional details were as follows:

Community well (did not meet criteria for other subgroups . . .