Persons who are eligible for both Medicare and Medicaid insurance coverage (dual eligible) represent 21% of total Medicare enrollment, but account for more than 36% of Medicare expenditures. The purpose of this study is to ascertain whether dual-eligible beneficiaries living in rural areas differ from their urban counterparts in demographic characteristics and Medicare expenditures.

Statement of the Problem: While it is known that rural beneficiaries are more likely to be dual eligible for Medicare and Medicaid, several questions remain. The status of rural minority dual eligible beneficiaries has never been examined, nor have regional differences.

Project goals: We will use Medicare claims files to delineate the demographic and expenditure patterns of Medicare only and Medicare/Medicaid enrollees (CMS data contain a dual-eligibility indicator), to ascertain any disparities experienced by rural and minority persons.

Methods: We will conduct a cross-sectional analysis of a 5% sample of Medicare claims from 2009. The population will be subset into two groups, Medicare only beneficiaries and dual eligible beneficiaries (as identified by the Centers for Medicare and Medicaid Control). Beneficiaries will be categorized by race/ethnicity and by residence, within which sex, age (65-74, 75-84, 85+), the number of chronic conditions (e.g. heart disease, diabetes, COPD, CHF, cancer), and presence of behavioral health issues (e.g., Alzheimer's disease) will be described. Expenditure estimates will be limited to Medicare only and will address physician, institutional and prescription drug claims.

Anticipated publications or products: A technical report summarizing project findings will be developed, along with shorter materials such as fact sheets and postcards. A short video will be developed to summarize study findings.

Publications

• Characteristics, Utilization Patterns, and Expenditures of Rural Dual Eligible Medicare Beneficiaries
  Policy Brief
  Rural and Minority Health Research Center
  Date: 11/2014
  This study analyzes the rural-urban differences regarding dual eligible beneficiaries and their races, regions of residence, patterns of utilizing health services, and Medicare expenditures.