Most US adults aged 65 or older qualify for Medicare, and many of them are also dually eligible for Medicaid benefits. Dual-eligible beneficiaries are some of the most disadvantaged older adult groups. They qualify for federal Medicare benefits, but the level of benefits they can receive under state Medicaid programs can vary greatly between states.
To help inform future policymaking, CHSE research in this area focuses on both the impact of policy changes within the Medicare program, as well as the complex merging of data for research on dual-eligible beneficiaries.
Hip/knee replacements are the most common inpatient surgeries for Medicare beneficiaries. Comprehensive Care for Joint Replacement (CJR) — Medicare's first mandatory bundled payment program— reflects a national move towards value-based payment. CHSE provides research assessing whether CJR affects disparities in joint replacement care.
- Association of Medicare bundled payment model with joint replacement care for people with dementia, 2022
- Association of Medicare Mandatory Bundled Payment Program With the Receipt of Elective Hip and Knee Replacement in White, Black, and Hispanic Beneficiaries, 2021
- Association of Medicare Mandatory Bundled Payment System for Hip and Knee Joint Replacement with Racial/Ethnic Difference in Joint Replacement Care, 2020
- Association of the Mandatory Medicare Bundled Payment with Joint Replacement Outcomes in Hospitals With Disadvantaged Patients, 2019
HOME & COMMUNITY BASED SERVICES (HCBS)
Home and community based services (HCBS) provide opportunities for Medicaid beneficiaries to receive services in their own home or community rather than institutions or other isolated settings. These programs serve a variety of targeted populations groups, such as people with intellectual or developmental disabilities, physical disabilities, and/or mental illnesses.
In 2021, Hyunjee Kim received a National Institute of Health R01 grant focused on individuals aged 65+ with Alzhiemer's disease and related dementias who receive both Medicaid and Medicare services. Dr. Kim is investigating the use of HCBS, health outcomes and health care costs for this population, with an emphasis on potential disparities in access and use of long-term supports and services across U.S. states with different policies.