We are unable to display your institutional affiliation without JavaScript turned on.
Browse Book and Journal Content on Project MUSE
OR

Find using OpenURL

Buy This Issue

High-Cost Users Among Dual Eligibles in Three Care Settings
Abstract

Abstract: This study compares the expenditure patterns and characteristics of high-cost dual eligibles to normative-cost dual eligibles within institutional and community settings. Using claims records for people dually eligible for both Medicare and Medicaid in 18 California counties (n=349,433) in 2000, high-cost users in the long-stay institutional care setting spent a much higher amount and a much greater proportion of total costs in Medi-Cal (61%) but spent less proportionally in Medicare (39%) than high-cost users in the long-term community care (66% of total costs from Medicare) or episodic care (79% of total costs from Medicare) setting. Although individuals who are long-stay nursing facility residents are high-cost in the overall sample, multinomial logistic regressions revealed that the impact of diseases/conditions on high-cost status varied within each setting. These findings suggest that policymakers and providers should consider care setting as an important component when designing disease management strategies.



You must be logged in through an institution that subscribes to this journal or book to access the full text.

Shibboleth

Shibboleth authentication is only available to registered institutions.

Project MUSE

For subscribing associations only.