ArticleThe American journal of managed care2022
Characteristics, utilization, and concentration of outpatient care for dual-eligible Medicare beneficiaries.
Article in The American journal of managed care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Impact of social determinants of health on physical therapy utilization in home health and outpatient settings: a retrospective cohort study.Physical therapy · 2026Article
- Medicare Plan Switching and Hospice Care Among Decedents With Advanced Cancer.JAMA network open · 2026Article
- Unplanned Surgery in Dually Eligible Beneficiaries for Conditions that Should Be Treated Electively.Annals of surgery · 2025Article
- Ambulatory care for individuals dually eligible for Medicare and Medicaid.Health affairs scholar · 2025Article
- Chronic conditions among transgender Medicare beneficiaries: Variation by race, ethnicity, and Medicaid dual-enrollment.Disability and health journal · 2025Article
- Social Vulnerability and Long-Term Cardiovascular Outcomes After COVID-19 Hospitalization: An Analysis of the American Heart Association COVID-19 Registry Linked With Medicare Claims Data.Journal of the American Heart Association · 2025Article
- Association between governmental spending on social services and health care use among low-income older adults.Health affairs scholar · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesTo characterize the (1) distribution of outpatient care for dual-eligible Medicare beneficiaries ("duals") and (2) intensity of outpatient care utilization of duals vs non-dual-eligible beneficiaries ("nonduals"). STUDY
designUsing data preceding the introduction of several outpatient alternative payment models, as well as Medicaid expansion, we evaluated the distribution of outpatient care across physician practices using a Lorenz curve and compared utilization of different outpatient services between duals and nonduals.
methodsWe defined practices that did (high dual) and did not (low dual and no dual) account for the large majority of visits based on the Lorenz curve and then performed descriptive statistics between these groups of practices. Practice-level outcomes included patient demographics, practice characteristics, and county measures of structural disadvantage and population health. Patient-level outcomes included number of outpatient visits and unique outpatient physicians, primary vs subspecialty care visits, and expenditures.
resultsNearly 80% of outpatient visits for duals were provided by 35% of practices. Compared with low-dual and no-dual practices, high-dual practices served more patients (1117.6 patients per high-dual practice vs 683.8 patients per low-dual practice and 447.5 patients per no-dual practice; P < .001) with more comorbidities (3.9 mean total Elixhauser comorbidities among patients served by high-dual practices vs 3.6 among low-dual practices and 3.3 among no-dual practices; P < .001). With regard to utilization, duals had 2 fewer outpatient visits per year compared with nonduals (13.3 vs 15.2; P < .001), with particularly fewer subspecialty care visits (6.5 vs 7.9; P < .001) despite having more comorbidities (3.5 vs 2.7; P < .001).
conclusionsOutpatient care for duals was concentrated among a small number of practices. Despite having more chronic conditions, duals had fewer outpatient visits. Duals and the practices that serve them may benefit from targeted policies to promote access and improve outcomes.
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