Beyond Spend-down: The Prevalence and Process of Transitions to Medicaid. Medicaid enrollment


  • Transition measure is full benefit enrollment, not estimated eligibility
  • Relies on data from 3 sources
    • Monthly Medicaid eligibility indicators for 2004-07 from MAX PS file
    • Monthly duals eligibility indicator for 2006-08 from Medicare beneficiary files (derived from MSIS)
    • Monthly Medicare “buy-in” indicators from beneficiary file 2004-09
  • Decision rules for transition
    • Based primarily on MAX indicators
    • MAX data suggest few “false positives” from buy-in and duals indicators, but about 20% “false negatives”
    • Assumed continuous enrollment after transition based on MAX analyses

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