National and State Trends in Enrollment and Spending for Dual Eligibles Under Age 65 in Medicaid Managed Care

This article uses 2005 and 2008 Medicaid Analytic eXtract (MAX) data to present spending and enrollment trends for adults with disabilities who are dually eligible for Medicare and Medicaid. Nationwide, the proportion of adult duals in managed care increased from 2005 to 2008, with the expansion of prepaid health plans (PHPs), particularly behavioral health PHPs, driving the increase. Although overall use of managed care has increased, there has been little expansion in the use of comprehensive managed care among adult dual eligible beneficiaries, particularly when compared with their Medicaid-only disabled adult peers. This imbalance suggests room to remove barriers preventing dually eligible adults, from enrolling in comprehensive, integrated managed care.