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KMID : 1170320040100020099
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Korean Journal of Health Economics and Policy
2004 Volume.10 No. 2 p.99 ~ p.115
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The Effects of Dual Eligibility on Prescription Drug Expenditures among Medicare Beneficiaries
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Moon Sang-Ho
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Abstract
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It has been an important financial issue in the U.S. Medicare system that health care expenses of dually eligible beneficiaries are much higher than those of Medicare only beneficiaries. Total health expenditures for the Medicaid-Medicare dual eligibles are more than double those of the non-dual eligibles. In 1999, total annual health expenditures(including Medicare, Medicaid, private, and out-of-pocket spending) averaged $16,278 for each dually eligible beneficiary compared with $7,396 on average for those who are not dually eligible.(Centers for Medicare and Medicaid Services, 2002) Dually eligible beneficiaries, who are covered by both Medicare and Medicaid, represent only one-fifth of each program’s enrollment, about 7 million in 1997, but account for a much larger share of each program’s spending.(Komisar H., et al, 2000) In 1999, these dually eligible beneficiaries accounted for about $50 billion in Medicare expenditures(24 percent of total Medicare spending) and $63 billion in Medicaid expenditures(35 percent of total Medicaid spending) nationwide, reflecting their relatively greater medical and long-term care demands.(Centers for Medicare and Medicaid Services, 2002) The dually eligible beneficiaries are the most costly population being served by publicly funded health care programs.(Ryan J. and N. Super, 2003)
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KEYWORD
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Medicare-Medicaid Dual eligibility, Prescription drug expenses, Zero-Inflated Negative Binomial(ZINB) Regression Analysis
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