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 Dual Eligibles Bear Brunt Of Dementia’s Ravages, Study Finds

Patients who were eligible for Medicare and Medicaid were more than three times more likely to suffer from dementia as Medicare-only patients, a new study by Avalere Health shows.

Thirteen percent of “dual eligibles” age 65 or older had been diagnosed with some form of dementia in 2009, Avalere’s study found. For patients age 65 or older who were eligible for Medicare only, the figure was 4 percent, Avalere found.

The disparities seem to continue even as the populations age, Avalere said. For those patients between 65 and 74 years old, 6 percent of dual eligibles and 1 percent of Medicare-only patients were diagnosed with dementia; patients between 75 and 84 years old, 15 percent of dual eligibles and 6 percent of Medicare-only beneficiaries suffered from dementia. For those 85 years or older, the ratio was 31 percent to 15 percent, Avalere found.

“We always expect duals to be more complex medically and to suffer disproportionately,” Avalere Manager Sally Rodriguez says. “But it’s always very surprising when you see the huge number --especially as you look at the very old.”

Avalere’s research was funded by the Scan Foundation, Rodriguez said. Researchers used conservative estimates, so Avalere’s findings may be under-reporting the size of the dementia problem, she adds.
Avalere’s research comes as states are scrambling to reform long term care rules and regulations under the Affordable Health Care Act.

“States need to tread lightly and be very cautious,” Rodriguez says. “We feel it’s important that people understand that dual eligibiles are very complex. You can’t just herd them into a single box and call it ‘managed care.’”
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