MedPAC, MACPAC publish data book on dual eligibles

WASHINGTON – The Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment and Access Commission (MACPAC) have released a newly updated data book: Beneficiaries Dually Eligible for Medicare and Medicaid.  

This edition describes the dually eligible population’s composition, service use and spending in calendar year 2022, and includes new data on Medicaid service use and spending for dually eligible beneficiaries in comprehensive Medicaid managed care. 

Key statistics in this year’s data book include: 

• There were 13.6 million people who were dually eligible for Medicare and Medicaid for at least one month in 2022. 

• People who are dually eligible for Medicare and Medicaid account for a disproportionate share of spending in both programs. Dually eligible beneficiaries totaled 20% of the Medicare population in 2022 but accounted for 36% of Medicare spending. Similarly, dually eligible beneficiaries accounted for 13% of all Medicaid beneficiaries but 27% of Medicaid spending. 

• Reflecting the continued shift from fee-for-service (FFS) to managed care in Medicare and Medicaid, in 2022 a majority of dually eligible beneficiaries (51%) were enrolled only in managed care for their Medicare benefits, 38% were enrolled only in Medicare FFS, and 11% spent part of the year in FFS and part of the year in managed care. For Medicaid services, 43% of dually eligible beneficiaries had at least one month of comprehensive managed care enrollment. 

• Looking specifically at comprehensive Medicaid managed care, dually eligible beneficiaries under age 65 had lower use of institutional long-term services and supports than individuals age 65 or older (4% vs. 11%) and lower expenditures (13 percent versus 36 percent). 

• Roughly one-quarter (27%) of all dually eligible beneficiaries had at least one month in which they were simultaneously enrolled in a Medicare managed care plan and a comprehensive Medicaid managed care plan. Another 49% of all dually eligible beneficiaries had some enrollment in Medicare managed care and/or comprehensive Medicaid managed care but not simultaneously.  

The data book is available on websites of both agencies: www.macpac.gov and www.medpac.gov.