State-Specific Dually Eligible Beneficiaries Data Profile: Request Form

Please indicate which of the following questions are of greatest interest to your State Agency. (You may select more than one.)

Where in my state do dually eligible beneficiaries live?

What are the demographic characteristics of the dually eligible beneficiaries in my state?

(e.g., age, gender, race)

What types of Medicare and Medicaid coverage do the dually eligible beneficiaries in my state have?

(for example, full vs. partial Medicaid coverage)

What percentage of the dually eligible beneficiaries in my state are enrolled in Medicare managed care programs and Medicaid managed care?

(e.g., Dual Eligible Special Needs Plans, Medicare-Medicaid Plans, the Program of All-Inclusive Care for the Elderly)

What types of chronic conditions do the dually eligible beneficiaries in my state have?

What types of Medicare and Medicaid services do the dually eligible beneficiaries in my state use?

How much do the Medicare and Medicaid programs spend on different services for dually eligible beneficiaries in my state?

How does the dually eligible population in my state compare to other states or the national average on any of the measures above?

What else would you like to know about the dually eligible population in your state?

Name

State Agency

State Agency Title

Email

ICRC will contact you shortly to set up a call and discuss your request.

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