Majority of Assisted Living Residents Dually Eligible for Medicare, Medicaid Live in Minority of Facilities

Beneficiaries dually eligible for Medicare and Medicaid are highly concentrated in assisted living facilities, experts reported in a research letter published in JAMA Health Forum.

“Higher concentration of assisted living residents dually eligible for Medicare and Medicaid could be a disadvantage because Medicaid reimbursement rates are generally lower than private pay rates,” wrote Portia Y. Cornell, PhD, of the Brown University Department of Health Services, Policy, and Practice in Providence, Rhode Island, and coauthors.

The cross-sectional study assessed the concentration of beneficiaries with dual eligibility in assisted living facilities with 25 or more beds and the association with Medicaid financing of assisted living services.

Among 471,695 adults across 12,168 assisted living communities, 25% were dually enrolled in Medicaid, according to the study. More than three-quarters (78%) of dually eligible beneficiaries resided in 20% of assisted living facilities.

Assisted living facilities with the lowest concentration of residents with dual eligibility were in states with state plan amendments to cover assisted living services, researchers reported. Facilities with the highest concentration were in states with no Medicaid coverage for assisted living.

“Future research is warranted to evaluate assisted living care quality by the distribution of dually eligible adults,” researchers advised.

Reference:
Cornell PY, Hua C, Rahman M, et al. Association of Medicaid financing and concentration of assisted living residents dually eligible for Medicare and Medicaid. JAMA Health Forum. Published online February 3, 2023. doi:10.1001/jamahealthforum.2022.5338