title: Recent Health Care Use and Medicaid Entry of Medicare Beneficiaries.
abstract: To examine the relationship between Medicaid entry and recent health care use among Medicare beneficiaries.
  
  
  
  We identified Medicare beneficiaries without full Medicaid or use of hospital or nursing home services in 2008 (N = 2,163,387). A discrete survival analysis estimated beneficiaries' monthly likelihood of entry into the full Medicaid program between January 2009 and June 2010.
  
  
  
  During the 18-month study period, Medicaid entry occurred for 1.1% and 3.7% of beneficiaries who aged into Medicare or originally qualified for Medicare due to disability, respectively. Among beneficiaries who aged into Medicare, 49% of new Medicaid participants had no use of inpatient, skilled nursing facility, or nursing home services during the study period. Individuals who recently used inpatient, skilled nursing facility or nursing home services had monthly rates of 1.9, 14.0, and 38.1 new Medicaid participants per 1,000 beneficiaries, respectively, compared with 0.4 new Medicaid participants per 1,000 beneficiaries with no recent use of these services.
  
  
  
  Although recent health care use predicted greater likelihood of Medicaid entry, half of new Medicaid participants used no hospital or nursing home care during the study period. These patterns should be considered when designing and evaluating interventions to reform health care delivery for dual-eligible beneficiaries.
authors.affiliation: Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Keohane
authors.affiliation: Department of Health Services, Policy and Practice, Brown University, Center of Innovation in Long-Term Services and Supports for Vulnerable Veterans, Providence VA Medical Center, Providence, Rhode Island.
authors.forename: Amal N
authors.initials: AN
authors.lastname: Trivedi
authors.affiliation: Department of Health Services, Policy and Practice, Brown University, Center of Innovation in Long-Term Services and Supports for Vulnerable Veterans, Providence VA Medical Center, Providence, Rhode Island.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004608:Eligibility Determination; D005260:Female; D006291:Health Policy; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D006278:Medicare; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*; D014481:United States
keywords: Dual-eligible beneficiaries; Hospitalizations; Long-term care