Findings from University of Pennsylvania Provides New Data on Managed Care (Is Medicare Home Health Care Utilization Substituting for Long-Term Care? Evidence From Dual Eligible Beneficiaries): Managed Care

2026 APR 15 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on Managed Care. According to news reporting from Philadelphia, Pennsylvania, by NewsRx journalists, research stated, “To examine the plausibly causal effect of Medicaid home- and community-based services (HCBS) use on Medicare community-initiated home health care (CIHHC) utilization among dual-eligible older adults and to provide evidence on whether access to home-based long-term care (LTC) reduces use of Medicare home health care, with potential implications for whether Medicare home health care is used as a substitute for LTC services when they are not or less accessible. To address the endogeneity of Medicaid HCBS use, we employ an instrumental variable, the proportion of Medicaid HCBS enrollment in other counties within the same state in the previous quarter, in conjunction with a state-border design in estimating the effect of Medicaid HCBS use on Medicare CIHHC and its heterogeneity.”

Financial support for this research came from National Institute on Aging.

The news correspondents obtained a quote from the research from the University of Pennsylvania, “We use national Medicare and Medicaid claims data along with home health and nursing home assessment data from 2016 to 2019. Our sample consists of 36,955,226 beneficiary-quarter-level observations of older adults (65+) dually enrolled in Medicaid and Medicare and residing in contiguous state-border counties. Medicaid HCBS use reduces Medicare CIHHC utilization by approximately 1.02 percentage points (95% CI: -1.73 to -0.32), representing about 44% of the sample mean. This effect is concentrated among beneficiaries enrolled in Medicare-Medicaid integrated care plans and those living in urban counties. Moreover, the reduction is most pronounced among older adults who live alone and have around-the-clock assistance needs. Our findings suggest a substitution between Medicaid HCBS and Medicare CIHHC among dual-eligible older adults at the margin of using Medicaid HCBS, a relationship that should be taken into account when evaluating either program.”

According to the news reporters, the research concluded: “These findings also align with the hypothesis that Medicare CIHHC is being used as a substitute for LTC, and the availability of home-based LTC may help to alleviate this potentially inefficient use.”

This research has been peer-reviewed.

For more information on this research see: Is Medicare Home Health Care Utilization Substituting for Long-Term Care? Evidence From Dual Eligible Beneficiaries. Health Services Research, 2026;61(2). Health Services Research can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - http://www.wiley.com/; Health Services Research - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1475-6773)

Our news journalists report that additional information may be obtained by contacting Rachel M. Werner, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States. Additional authors for this research include Mingyu Qi, Megan Huisingh-Scheetz and R. Tamara Konetzka.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1111/1475-6773.70109. 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.

Publisher contact information for the journal Health Services Research is: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA.

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