Blog & News
New SHADAC Resource Explores and Evaluates Available Data Sources to Research Integrated Care for Dual EligiblesApril 1, 2021:
The importance of improving care for individuals enrolled in both Medicare and Medicaid (dual eligibles) has received considerable attention in recent years.1,2,3 Extensive research has shown that dual eligibles account for a disproportionate share of spending within both programs, and the lack of integration between the two programs contributes not only to excess costs but also lower quality care.4,5,6 As a result, states and the federal government have developed a variety of models aimed at improving integration of care for dual eligibles.
A new report by SHADAC researchers Lacey Hartman and Elizabeth Lukanen, conducted with support from the Arnold Ventures Foundation, describes the strengths and limitations of existing data sources that could be used to study the broad topic of integrated care for dual eligibles. A primary focus is whether these data can address research questions aimed at improving care for dual eligibles. The paper summarizes findings by assessing the data sources across four focus areas that are critical to research aimed at dual eligibles: 1) enrollment in integrated care models; 2) analysis of priority subpopulations; 3) LTSS; and 4) enrollee social needs.
The report provides a systematic review of 34 data sources that can produce nationally representative estimates for dually eligible individuals (and/or estimates for all 50 states) and have the potential to inform research on integrated care models. Selections were made based on SHADAC’s extensive prior knowledge in working with a wide variety of data sources, our recent work developing an inventory of evaluations of integrated care models, and a scan of relevant and widely used data repositories such as the Research Data Assistance Center (ResDAC) and the Chronic Condition Data Warehouse (CCW).
The paper also provides an overview of important gaps and deficiencies within the data (and their implications for researchers seeking to evaluate the impact of integrated care for dual eligible) and concludes with a set of recommendations aimed at addressing these gaps and advancing the availability of comprehensive, high-quality data for research in this area.
In addition to this report, SHADAC has produced a companion Excel table that contains the full abstraction details for each data source.
1 Rizer, A. COVID-19: If ever there was a time to care about Medicare-Medicaid integration, it’s now. Arnold Ventures. https://www.arnoldventures.org/stories/covid-19-if-ever-there-was-a-time-to-care-about-medicare-medicaid-integration-its-now/
2 Center for Health Care Strategies (CHCS). (2021). Promoting integrated care for dual eligibles (PRIDE). https://www.chcs.org/project/promoting-integrated-care-for-dual-eligibles-pride/
3 Integrated Care Resource Center (ICRC). (2021). Home. https://www.integratedcareresourcecenter.com/
4 Medicaid and CHIP Payment and Access Commission (MACPAC). (2020). Integrating care for dually eligible beneficiaries: Background and context [Report to Congress on Medicaid and CHIP; Chapter 1]. MACPAC. https://www.macpac.gov/wp-content/uploads/2020/06/Chapter-1-Integrating-Care-for-Dually-Eligible-Beneficiaries-Background-and-Context.pdf
5 Medicare Payment Advisory Commission (MedPAC). (2020). Dual-eligible beneficiaries [Data book; Section 4]. MedPAC. http://www.medpac.gov/docs/default-source/data-book/july2020_databook_sec4_sec.pdf?sfvrsn=0
6 Medicare-Medicaid Coordination Office. (2015). Fiscal year 2015 report to Congress. Centers for Medicare & Medicaid Services (CMS). https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/MMCO_2015_RTC.pdf