title: State payment limitations on Medicare cost-sharing: impact on dually eligible beneficiaries.
abstract: The Balanced Budget Act (BBA) of 1997 allowed states to limit how much their Medicaid programs contributed toward the Medicare cost-sharing liability of dually eligible beneficiaries. Policymakers have grown concerned that such limitations may affect access to care for these beneficiaries. We used a quasi-experimental design to analyze changes in access from 1996 to 1998, using Medicare and Medicaid data from nine states. Cost-sharing payments fell in six of the nine states following the BBA, and access to outpatient physician visits for dually eligible beneficiaries was reduced relative to non-dually eligible beneficiaries in those states.
authors.affiliation: Division for Health Services and Social Policy Research, RTI International, 411 Waverley Oakes Road, Suite 330, Waltham, MA 02452-8414, USA. jmitchell@rti.org
authors.forename: Janet B
authors.initials: JB
authors.lastname: Mitchell
authors.forename: Susan G
authors.initials: SG
authors.lastname: Haber
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D017047:Cost Sharing; D004608:Eligibility Determination; D006297:Health Services Accessibility / Q000191:economics* / Q000639:trends; D006801:Humans; D008484:Medicaid / Q000191:economics* / Q000331:legislation & jurisprudence; D006278:Medicare / Q000191:economics* / Q000331:legislation & jurisprudence; D017059:Models, Econometric; D015999:Multivariate Analysis; D011907:Rate Setting and Review / Q000331:legislation & jurisprudence; D012044:Regression Analysis; D013221:State Health Plans / Q000191:economics / Q000331:legislation & jurisprudence*; D014481:United States