J Wyatt Koma, Zhiyou Yang, Mary Price, David Cheng, Felippe Marcondes, Kobi Khong, John Hsu, Margarita Alegría, Joseph P Newhouse, Vicki Fung
{"title":"合格的医疗保险受益人计划:低收入受益人的登记趋势和特征。","authors":"J Wyatt Koma, Zhiyou Yang, Mary Price, David Cheng, Felippe Marcondes, Kobi Khong, John Hsu, Margarita Alegría, Joseph P Newhouse, Vicki Fung","doi":"10.1377/hlthaff.2024.01189","DOIUrl":null,"url":null,"abstract":"<p><p>To address low take-up of Medicare Savings Programs for low-income Medicare beneficiaries, the Centers for Medicare and Medicaid Services issued regulations in 2023 aimed at streamlining the enrollment process. We analyzed 2016-22 data from the Medicare Current Beneficiary Survey to examine recent take-up of the largest and most generous Medicare Savings Program, the Qualified Medicare Beneficiary (QMB) program. We compared beneficiary characteristics and cost-related barriers to care among QMB enrollees and beneficiaries who were eligible but not enrolled. QMB take-up rose from 62 percent in 2016 to 66 percent in 2022. QMB-eligible beneficiaries who were Asian or Hispanic were more likely than eligible White beneficiaries to enroll in the program. Eligible beneficiaries younger than age sixty-five were more likely to enroll than those ages sixty-five and older, and beneficiaries in Medicaid expansion states were more likely to enroll than those in nonexpansion states. QMB enrollees were less likely than Medicare beneficiaries who were eligible but not enrolled to report delaying care because of cost or having problems paying for care. These findings suggest that additional policies and programs may be needed to increase QMB take-up and to improve health care access and affordability for millions of low-income Medicare beneficiaries.</p>","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 7","pages":"878-886"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Qualified Medicare Beneficiary Program: Enrollment Trends And Characteristics Of Low-Income Beneficiaries.\",\"authors\":\"J Wyatt Koma, Zhiyou Yang, Mary Price, David Cheng, Felippe Marcondes, Kobi Khong, John Hsu, Margarita Alegría, Joseph P Newhouse, Vicki Fung\",\"doi\":\"10.1377/hlthaff.2024.01189\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>To address low take-up of Medicare Savings Programs for low-income Medicare beneficiaries, the Centers for Medicare and Medicaid Services issued regulations in 2023 aimed at streamlining the enrollment process. We analyzed 2016-22 data from the Medicare Current Beneficiary Survey to examine recent take-up of the largest and most generous Medicare Savings Program, the Qualified Medicare Beneficiary (QMB) program. We compared beneficiary characteristics and cost-related barriers to care among QMB enrollees and beneficiaries who were eligible but not enrolled. QMB take-up rose from 62 percent in 2016 to 66 percent in 2022. QMB-eligible beneficiaries who were Asian or Hispanic were more likely than eligible White beneficiaries to enroll in the program. Eligible beneficiaries younger than age sixty-five were more likely to enroll than those ages sixty-five and older, and beneficiaries in Medicaid expansion states were more likely to enroll than those in nonexpansion states. QMB enrollees were less likely than Medicare beneficiaries who were eligible but not enrolled to report delaying care because of cost or having problems paying for care. These findings suggest that additional policies and programs may be needed to increase QMB take-up and to improve health care access and affordability for millions of low-income Medicare beneficiaries.</p>\",\"PeriodicalId\":519943,\"journal\":{\"name\":\"Health affairs (Project Hope)\",\"volume\":\"44 7\",\"pages\":\"878-886\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health affairs (Project Hope)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1377/hlthaff.2024.01189\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health affairs (Project Hope)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1377/hlthaff.2024.01189","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Qualified Medicare Beneficiary Program: Enrollment Trends And Characteristics Of Low-Income Beneficiaries.
To address low take-up of Medicare Savings Programs for low-income Medicare beneficiaries, the Centers for Medicare and Medicaid Services issued regulations in 2023 aimed at streamlining the enrollment process. We analyzed 2016-22 data from the Medicare Current Beneficiary Survey to examine recent take-up of the largest and most generous Medicare Savings Program, the Qualified Medicare Beneficiary (QMB) program. We compared beneficiary characteristics and cost-related barriers to care among QMB enrollees and beneficiaries who were eligible but not enrolled. QMB take-up rose from 62 percent in 2016 to 66 percent in 2022. QMB-eligible beneficiaries who were Asian or Hispanic were more likely than eligible White beneficiaries to enroll in the program. Eligible beneficiaries younger than age sixty-five were more likely to enroll than those ages sixty-five and older, and beneficiaries in Medicaid expansion states were more likely to enroll than those in nonexpansion states. QMB enrollees were less likely than Medicare beneficiaries who were eligible but not enrolled to report delaying care because of cost or having problems paying for care. These findings suggest that additional policies and programs may be needed to increase QMB take-up and to improve health care access and affordability for millions of low-income Medicare beneficiaries.