Factors Predicting Transitions from Medicare-Only to Medicare-Medicaid Enrollee Status

Publisher: Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy
Jan 31, 2014
Authors
Wilfredo Lim, Carol V. Irvin, and Rosemary Borck
  • Emergency department visits, inpatient stays, and nursing home utilization are predictive of transition to Medicare-Medicaid enrollee status.
  • Residence in a skilled nursing facility and having a dementia-related condition are predictive of entry to nursing home care not financed by the Medicare skilled nursing facility benefit. 

This study identifies factors predicting the transition to dual eligibility for Medicare and Medicaid coverage among Medicare-only beneficiaries, as well as factors predicting entry to nursing home care not financed by the Medicare skilled nursing facility benefit. Factors were identified by estimating separate multivariate logistic regression models. Emergency department visits, inpatient stays, and nursing home utilization are predictive of transition to Medicare-Medicaid enrollee status. Residence in a skilled nursing facility and having a dementia-related condition are predictive of entry to nursing home care not financed by the Medicare skilled nursing facility benefit.