{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:10:27Z","timestamp":1791357027027,"version":"4.3.1"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T00:00:00Z","timestamp":1706054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG073179"],"award-info":[{"award-number":["R01AG073179"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Given high rates of un\u2010 and underemployment among disabled people, adults with intellectual and developmental disabilities rely on Medicaid, Medicare, or both to pay for healthcare. Many disabled adults are Medicare eligible before the age of 65 but little is known as to why some receive Medicare services while others do not. We described the duration of Medicare enrollment for adults with intellectual and developmental disabilities in 2019 and then compared demographics by enrollment type (Medicare\u2010only, Medicaid\u2010only, dual\u2010enrolled). Additionally, we examined the percent in each enrollment type by state, and differences in enrollment type for those with Down syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources and Study Setting<\/jats:title><jats:p>2019 Medicare and Medicaid claims data for all adults (\u226518\u2009years) in the US with claim codes for intellectual disability, Down syndrome, or autism at any time between 2011 and 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Administrative claims cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection and Abstraction Methods<\/jats:title><jats:p>Data were from the Transformed Medicaid Statistical Information System Analytic Files and Medicare Beneficiary Summary files.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principle Findings<\/jats:title><jats:p>In 2019, Medicare insured 582,868 adults with identified intellectual disability, autism, or Down syndrome. Of 582,868 Medicare beneficiaries, 149,172 were Medicare only and 433,396 were dual\u2010enrolled. Most Medicare enrollees were enrolled as child dependents (61.5%) Medicaid\u2010only enrollees (<jats:italic>N<\/jats:italic>\u2009=\u2009819,256) were less likely to be white non\u2010Hispanic (58.5% white non\u2010Hispanic vs. 72.9% white non\u2010Hispanic in dual\u2010enrolled), more likely to be Hispanic (19.6% Hispanic vs. 9.2% Hispanic in dual\u2010enrolled) and were younger (mean 34.2\u2009years vs. 50.5\u2009years dual\u2010enrolled).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is heterogeneity in public insurance enrollment which is associated with state and disability type. Action is needed to ensure all are insured in the program that works for their healthcare needs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.14287","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T09:24:25Z","timestamp":1706088265000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Medicare, Medicaid, and dual enrollment for adults with intellectual and developmental disabilities"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9146-4497","authenticated-orcid":false,"given":"Eric","family":"Rubenstein","sequence":"first","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salina","family":"Tewolde","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1336-3594","authenticated-orcid":false,"given":"A. Alex","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Health Policy Law and Management Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Droscha","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel Midori","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Michals","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Data Analytics Center Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Skotko","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,24]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Handbook of intellectual and developmental disabilities","author":"Durkin M","year":"2020"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1057\/978-1-137-52499-7_3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875\u2010015\u20100329\u20103"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201900265"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jar.12182"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3233\/JVR\u2010130658"},{"key":"e_1_2_8_8_1","first-page":"17","article-title":"Supplemental security income and social security disability insurance beneficiaries with intellectual disability","volume":"77","author":"Livermore GA","year":"2017","journal-title":"Soc Sec Bull"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/aur.2173"},{"key":"e_1_2_8_10_1","volume-title":"Introduction to Medicaid","author":"Center on Budget and Policy Priorities","year":"2020"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.2320"},{"key":"e_1_2_8_12_1","unstructured":"Publication No. 05\u201010043 Medicare (Social Securit Administration)(2023).https:\/\/www.ssa.gov\/pubs\/EN-05-10043.pdf"},{"key":"e_1_2_8_13_1","volume-title":"Perspectives: Supplemental Security Income and Social Security Disability Insurance Beneficiaries with Intellectual Disability","author":"Livermore GA","year":"2017"},{"key":"e_1_2_8_14_1","volume-title":"Dually Eligible Beneficiaries Under Medicare and Medicaid","author":"Medicare Learning Network","year":"2020"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1352\/1934\u20109556\u201057.5.405"},{"issue":"2","key":"e_1_2_8_16_1","first-page":"29","article-title":"Accounting for geographic variation in social security disability program participation perspectives","volume":"78","author":"Gettens J","year":"2018","journal-title":"Soc Secur Bull"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010019\u20100143\u20107"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1706537"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1352\/1944\u20107558\u2010123.4.371"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2021.3815"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ppar\/prab009"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1257\/pol.20180076"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615\u2010015\u20100182\u2010z"},{"key":"e_1_2_8_24_1","volume-title":"Databook: Beneficiaries dually eligible for Medicare and Medicaid","author":"Medicare Payment Advisory Commission","year":"2017"},{"key":"e_1_2_8_25_1","unstructured":"Center for Medicare and Medicaid Services.Dual\u2010Eligible Enrollment. 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