{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:08:52Z","timestamp":1789013332712,"version":"build-2803163510"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients dually eligible for Medicare and Medicaid have higher mortality rates and disparate outcomes for acute cardiovascular conditions compared with those eligible for Medicare alone. However, the association between dual eligibility, cardiovascular disease (CVD) multimorbidity development, and subsequent mortality has not been well characterized in patients dually eligible for Medicare and Medicaid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed Medicare claims data from a 5% random sample of fee\u2010for\u2010service beneficiaries (2010\u20132019). Our primary exposure was Medicaid dual eligibility. The primary outcomes were the development of incident CVD or cardiovascular multimorbidity (defined as \u22652 of the following conditions: stroke\/transient ischemic attack, myocardial infarction, atrial fibrillation, heart failure, and chronic ischemic heart disease). The secondary outcome was death. Multistate survival models were used to estimate hazards of progression from no CVD comorbidity to incident CVD, CVD multimorbidity, and death before and after adjustment for demographics and medical comorbidity burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">In total, 2\u2009189\u2009382 patients (12.9% of whom were dual eligible for Medicaid) were included. Over a median 5\u2009years of follow\u2010up, non\u2013dual\u2010eligible beneficiaries had 1 more year of survival free from CVD than dual\u2010eligible beneficiaries (4.89 versus 5.95\u2009years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Dual\u2010eligible beneficiaries were more likely to develop CVD and multimorbidity and had higher mortality rates before and after adjustment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.042150","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:13:04Z","timestamp":1785496384000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular Multimorbidity and Associated Mortality Among Medicare Beneficiaries Dually Eligible for Medicaid"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5770-2088","authenticated-orcid":false,"given":"Cheryl","family":"Kalapura","sequence":"first","affiliation":[{"name":"Duke University School of Medicine","place":["Durham"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3222-1719","authenticated-orcid":false,"given":"Robert J.","family":"Mentz","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Duke University School of Medicine","place":["Durham"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6912-7374","authenticated-orcid":false,"given":"Stephen J.","family":"Greene","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Duke University School of Medicine","place":["Durham"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0389-6434","authenticated-orcid":false,"given":"Bradley G.","family":"Hammill","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine","place":["Durham"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3914-8419","authenticated-orcid":false,"given":"Brian","family":"Mac Grory","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine","place":["Durham"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0390-3673","authenticated-orcid":false,"given":"Fan","family":"Li","sequence":"additional","affiliation":[{"name":"Duke University","place":["Durham"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1237-1162","authenticated-orcid":false,"given":"Ying","family":"Xian","sequence":"additional","affiliation":[{"name":"University of Texas\u2013Southwestern","place":["Dallas"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8257-7561","authenticated-orcid":false,"given":"Emily C.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine","place":["Durham"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5728-8872","authenticated-orcid":false,"given":"Jay B.","family":"Lusk","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine","place":["Durham"]},{"name":"University of North Carolina at Chapel Hill","place":["Chapel Hill"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001123"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-022-02427-9"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S97248"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.0385"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.4226"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30571-8"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2022.01574"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-6-88"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12591"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m40"},{"key":"e_1_3_1_12_2","volume-title":"A Profile of Medicare\u2010Medicaid Enrollees (Dual Eligibles)","author":"Pe\u00f1a MT","year":"2013","unstructured":"Pe\u00f1a MT, Mohamed M, Burns A, Biniek JF, Ochieng N, Chidambaram P. A Profile of Medicare\u2010Medicaid Enrollees (Dual Eligibles). KFF; 2013. Accessed June 1, 2024. https:\/\/www.kff.org\/medicare\/a\u2010profile\u2010of\u2010medicare\u2010medicaid\u2010enrollees\u2010dual\u2010eligibles\/"},{"key":"e_1_3_1_13_2","volume-title":"Data Analysis Brief: Medicare\u2010Medicaid Dual Enrollment 2006\u20132019","author":"Centers for Medicare & Medicaid Services","year":"2024","unstructured":"Centers for Medicare & Medicaid Services . Data Analysis Brief: Medicare\u2010Medicaid Dual Enrollment 2006\u20132019. Centers for Medicare & Medicaid Services; 2024."},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1021"},{"key":"e_1_3_1_15_2","volume-title":"Chronic Disease and Co\u2010Morbidity Among Dual Eligibles: Implications for Patterns of Medicaid and Medicare Service Use and Spending","author":"Lyons B","year":"2010","unstructured":"Lyons B. Chronic Disease and Co\u2010Morbidity Among Dual Eligibles: Implications for Patterns of Medicaid and Medicare Service Use and Spending. KFF; 2010. Accessed August 25, 2025. https:\/\/www.kff.org\/affordable\u2010care\u2010act\/chronic\u2010disease\u2010and\u2010co\u2010morbidity\u2010among\u2010dual\/"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0135834"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.30.4.06"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000174293.17959.a1"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2006.12.022"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000735"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1613412"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i2214"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.9643"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1715455"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","unstructured":"Verma S. Better Care For People Dually Eligible For Medicare and Medicaid. Health Affairs Forefront. 10.1377\/forefront.20190423.701475.","DOI":"10.1377\/forefront.20190423.701475"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029652"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.28.1.136"},{"key":"e_1_3_1_29_2","unstructured":"Financial Alignment Initiative (FAI) | CMS. Accessed August 25 2025. https:\/\/www.cms.gov\/medicaid\u2010chip\/medicare\u2010coordination\/financial\u2010alignment."}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.042150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:41:54Z","timestamp":1789011714000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.042150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":28,"journal-issue":{"issue":"15","published-print":{"date-parts":[[2026,8,4]]}},"alternative-id":["10.1161\/JAHA.125.042150"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.042150","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]},"assertion":[{"value":"2025-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e042150"}}