Health System Affiliation and Care for Dual-Eligible and Non–Dual-Eligible Medicare Beneficiaries

How is health system affiliation associated with disparities in quality of care and health care utilization between dual-eligible and non–dual-eligible Medicare beneficiaries?Using a national sample of primary care physician organizations, this cohort study identified widening disparities for dual-eligible beneficiaries in diabetic eye examinations and follow-up after acute events (3.5 percentage point greater reduction vs non–dual-eligible beneficiaries) after health system affiliation. Although continuity of care and statin prescribing improved, primary care physician visit disparities widened, with 21 fewer visits per 100 beneficiaries.This study suggests that health system affiliation is associated with increased disparities for dual-eligible beneficiaries, highlighting the need for improved strategies to enhance equity and access.

Corresponding Author: Justin W. Timbie, PhD, RAND Corporation, 1200 S Hayes St, Arlington, VA 22202 (jtimbie@rand.org).

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