How switching from Medicaid to Medicare affects costs and access to care at age 65
The Transition from Medicaid to Medicare and Impacts on Disparities in Coverage and Care
This project looks at whether people who move from Medicaid to Medicare when they turn 65 face higher out-of-pocket costs and differences in access to care, especially for Black and Hispanic beneficiaries.
Quick facts
| Grant type | R01 grant |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Massachusetts General Hospital NIH-funded |
| Lab location | 1 site (Boston, United States) |
| Project ID | NIH-11238890 on NIH RePORTER |
What this research studies
If you turned 65 while enrolled in Medicaid, researchers will follow your Medicaid and Medicare enrollment, claims, and encounter records from 2016–2023 to see what happens after you transition to Medicare. They will measure who gets Medicare cost-sharing subsidies, how much people pay out-of-pocket, and whether use of necessary care changes after the switch. The team will compare outcomes for people in states that expanded extra subsidy eligibility to those in states that did not to see whether policies reduce disparities. They will pay special attention to differences by race and ethnicity to understand whether Black and Hispanic beneficiaries are less likely to get help or more likely to face worse access.
Who could benefit from this research
Good fit: People who were enrolled in Medicaid and then became Medicare-eligible at age 65 between 2016 and 2023, particularly low-income individuals (around 100–150% of the federal poverty level) and Black or Hispanic beneficiaries.
Not a fit: People who are younger than 65, never enrolled in Medicaid, or have higher incomes well above subsidy thresholds are unlikely to be affected by the findings.
Why it matters
Potential benefit: Findings could inform policy changes to reduce out-of-pocket costs and narrow racial/ethnic gaps in access to care for people moving from Medicaid to Medicare.
How similar studies have performed: Prior research has shown higher cost-sharing can reduce needed care and worsen outcomes, but there is limited evidence about whether state-level expansions of Medicare subsidy eligibility reduce racial/ethnic disparities.
Where this research is happening
Boston, United States
- Massachusetts General Hospital — Boston, United States (Active)
Researchers
- Principal investigator: Fung, Vicki — Massachusetts General Hospital
- Study coordinator: Fung, Vicki
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page below.