Traditional Medicare Episode-Related Spending on Postacute Care for Dual-Eligible and Medicare-Only Beneficiaries, 2009-2017

Dual-eligible beneficiaries with Medicare and Medicaid coverage generally have greater utilization and spending levels than Medicare-only beneficiaries on postacute services, raising questions about how strategies to curb postacute spending will affect dual-eligible beneficiaries. We compared trends in postacute spending and use related to inpatient episodes at a population and episode level for dual-eligible and Medicare-only beneficiaries over the years 2009-2017. Although dual-eligible beneficiaries had consistently higher inpatient and postacute service use and spending than Medicare-only populations, both populations experienced similar declines in inpatient and postacute measures over time. Conditional on having an inpatient stay, most types of postacute service use increased regardless of dual-eligible status. These consistent patterns in episode-related postacute spending for Medicare-only and dual-eligible beneficiaries-decreased episode-related spending and use on a per beneficiary basis and increased use and spending on a per episode basis-suggest that changing patterns of care affect both populations.

Automated summary

Dual-eligible beneficiaries with Medicare and Medicaid coverage have higher utilization and spending levels on postacute services compared to Medicare-only beneficiaries, but both populations experienced similar declines over the years. Regardless of dual-eligible status, most types of postacute service use increased during inpatient stays.