Medicare-Medicaid Dual-Eligible

A 2020 study examined the feasibility of using substance use disorder (SUD) patient intake assessment data as source of information for treatment planning.

Prior research from the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) and U.S. Department of Housing and Urban Development (HUD) Office of Policy Development and Research (PD&R) show older adults receiving federal housing assistance face disproportionately high rates of chronic conditions and health care utilization.

The Inflation Reduction Act’s (IRA) expanded financial assistance in Medicare’s Low-Income Subsidy (LIS) Program would have benefited nearly 461,000 Partial LIS enrollees had the provision been in effect in 2020. An additional 2.9 million Part D enrollees who were eligible but not enrolled in LIS would also have benefited from the program.

Stakeholders, researchers, and policymakers have identified varying nursing home ownership structures and ownership transactions as potentially influencing the quality of care delivered to vulnerable residents.

This research report updates prior reports on Medicare FFS telehealth trends during the COVID-19 public health emergency with data through end of 2021, by beneficiary characteristics, visit specialty and geography including by state. Medicare telehealth flexibilities during the COVID-19 pandemic continued to encourage use of telehealth among Medicare beneficiaries in 2021.

Telehealth utilization has changed over time since the steep increase from the early stages of the COVID-19 pandemic. This report updates prior findings on national trends of telehealth use through an analysis using the Census Bureau’s Household Pulse Survey data from April 2021 through August 2022.

Payers across the health care spectrum have begun transitioning from paying for quantity toward paying for quality. These value-based payment (VBP) programs vary in scope and focus, but generally share the goals of improving cost-savings and linking payments to value rather than volume.

Opioid use was very common among the long-term care (LTC) residents in our sample. Perhaps reflecting their post-acute rehabilitative needs, discharged residents were more likely to have opioid use prior to LTC admission and at the beginning of the LTC stay.

Prescriptions dispensed for antipsychotics in nursing homes and assisted living facilities increased since the beginning of the pandemic, with 20.8 thousand dispensed in 2020 compared to 20.5 thousand in 2019. This represents a 1.5% increase in total prescriptions since the beginning of the pandemic despite lower resident census levels in long-term care facilities (LTCFs).

Dual eligible beneficiaries are an important subset of the Medicare and Medicaid populations because they have a high prevalence of chronic conditions and disabilities, substantial care needs, and high health care and long-term services and supports (LTSS) utilization and costs.