Dual-Eligible Medicaid Spending: Are We on the Flat of the Curve?

Melissa A. BoyleJoanna N. Lahey Margaret E. Czervionke

WP#2008-16

Abstract

For the U.S. Medicare population as a whole, previous studies show that additional medical spending at the margin is ineffective. For the elderly population overall, higher spending on health care does not appear to improve health outcomes or quality of life. The Medicaid literature, however, has shown benefits of increased spending on lower income populations such as single mothers. This suggests that there may be beneficial effects of spending on different segments of the Medicare population, particularly those most at risk – the low-income elderly. We use data from the Medicare Current Beneficiary Survey to examine whether increased medical spending results in differential use of medical services and/or improved health outcomes for low-income elderly who are dually-eligible for Medicare and Medicaid. We utilize state-level variation in Medicaid spending in a difference-in differences framework comparing the dual-eligible population to the near-eligible population just above the means test cutoff to investigate whether additional spending by Medicaid results in differences in health and service use for low-income elderly. Preliminary results suggest that additional spending leads to small increases in drug spending and no other significant increases in utilization or health improvements.