Findings from University of Pennsylvania in Managed Care Reported (Ambulatory care for individuals dually eligible for Medicare and Medicaid): Managed Care

2025 SEP 11 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Managed Care have been published. According to news reporting out of Philadelphia, Pennsylvania, by NewsRx editors, research stated, “Individuals dually eligible for insurance through both Medicaid and Medicare (‘duals’) have more comorbidities, higher costs, and poorer outcomes compared to other groups. Unfortunately, policy and care redesign initiatives suffer from limited knowledge about ambulatory care patterns among duals.”

Financial support for this research came from Arnold Ventures.

Our news journalists obtained a quote from the research from the University of Pennsylvania, “Using 2022 Medicare fee-for-service claims and other sources of clinician and geographic data, we described care patterns for ambulatory services among dual vs non-duals. Our sample consisted of 967 820 dual and 4 600 486 non-dual individuals receiving a total of 67 122 906 ambulatory services from 106 545 practices and 815 827 clinicians. We found that duals received fewer ambulatory, in particular subspecialty, services than non-duals, while duals received slightly more services through primary care physicians and advanced practice professionals. Among duals, most services were provided in office rather than federally qualified health centers or rural health clinics by a disproportionally small number of geographically dispersed practices and clinicians. High-dual practices and clinicians differed from non-high dual counterparts with respect to multiple characteristics.”

According to the news editors, the research concluded: “These differences highlight the opportunity to improve access and outcomes among duals by targeting policy and practice changes toward certain groups and clinicians.”

This research has been peer-reviewed.

For more information on this research see: Ambulatory care for individuals dually eligible for Medicare and Medicaid. Health Affairs Scholar, 2025;3(8).

Our news journalists report that additional information may be obtained by contacting Paula Chatterjee, Dept. of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States. Additional authors for this research include Joshua M. Liao, Yueming Zhao, Isabelle J. Carroll, Danielle S. Browne, Austin S. Kilaru, Aidan P. Crowley, David Pagnotti, Torrey Shirk, Deborah S. Cousins and Amol S. Navathe.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1093/haschl/qxaf148. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

(Our reports deliver fact-based news of research and discoveries from around the world.)