Medicaid Buy-In Doubles Enrollment, Expenditures

Mathematica gleaned the study results from Buy-In participant files provided by the states, Medicaid eligibility and claims files, Medicare claims records, and administrative data from the Social Security Administration.

The report also found that:

• Prescription drugs accounted for the largest share of total Medicaid spending (36% or $436 per month); more participants (91%) used this service than any other. Community long-term care services represented the second-largest share of spending (22%, or $270 per month) and were used by 15% of participants.



• Inpatient hospital expenditures accounted for the largest share of Medicare spending (44% or $264 per month) among Buy-In participants who are dually enrolled in Medicare and Medicaid.



• Not surprisingly, Medicare expenditures increased with the age of the participant. For example, typical monthly Medicare costs for those ages 65 and older were $785, compared with costs of $378 for those 30 and younger. Medicaid expenditures showed a different pattern: Adults ages 31 to 50 had the highest level of Medicaid expenditures.