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New resources for investigators who are interested in conducting research on the care needs and patterns of low-income older adults and people with disabilities

Arnold Ventures seeks to address some of the most pressing policy challenges facing our country. Our work within the health care sector is driven by a belief that our current system costs too much and struggles to adequately care for people with one condition, let alone a complex array of conditions. There is no population for whom this is truer than those who are dually eligible for Medicare and Medicaid. Individuals who are dual-eligible account for a disproportionate share of Medicare and Medicaid spending, yet the outcomes we get for these dollars are poor. They are more likely to have inpatient stays, visit emergency rooms, and use nursing homes than their Medicare-only counterparts.

These health needs — and the high cost of caring for this population — should motivate policymakers to pursue reforms to state and federal policy. However, one of the limiting factors in developing new policy is the evidence gap. Relatively few investigators use both Medicare and Medicaid data when conducting research and those that do are at just a few institutions. Resources to help investigators harness the available data have the potential to grow the evidence base in response to policymakers needs.

About the Toolkit

This toolkit is designed to support investigators interested in the health needs and care experiences of low-income older adults and people with disabilities who have both Medicare and Medicaid coverage. These resources were developed by grantees with support from the Arnold Ventures Complex Care initiative:

Complex Care Research Agenda

To motivate researchers to study the dual-eligible population, Arnold Ventures has identified priorities and questions based on gaps in the evidence.

SHADAC Report on Dual-Eligibles

This report summarizes the findings of a systematic review of data sources that could be used to study the broad topic of integrated care for dual-eligibles.

Human-Centered Design Research on Dual-Eligibles

Using a Human-Centered Design (HCD) approach, IMPAQ has identified the pain points, gaps, and opportunities that dual-eligible individuals experience when navigating and receiving care.

Data Quality Reports

In November 2020, CMS announced the availability of new Medicaid administrative data files, namely the Transformed Medicaid Statistical Information System (T‑MSIS) Analytic Files (TAF). The Urban Institute, in three reports, contributes to knowledge of the TAF’s data quality by specifically focusing on issues related to dual beneficiaries.

Other Resources to Support Understanding of the Dual-Eligible Population and Integrated Care

Medicare-Medicaid Integration: Essential Program Elements for Integrated Care Programs for Dually Eligible Individuals, 2021

Listening to Dually Eligible Individuals: Person-Centered Enrollment Strategies for Integrated Care, 2021

Why Dually Eligible Beneficiaries Stay or Leave Integrated Care Plans, 2021

Addressing Dual-Eligible Beneficiaries’ Social Determinants of Health Through Dual-Eligible Special Needs Plans, 2020

A Pathway to Full Integration of Care for Medicare-Medicaid Beneficiaries, 2020

Dual Medicare-Medicaid Enrollees | Urban Institute

A Profile of Medicare-Medicaid Enrollees (Dual Eligibles)