Characteristics of Medicare Beneficiaries With Intellectual or Developmental Disabilities.
Medicare and Medicaid data agree: adults with IDD carry multiple chronic illnesses and land in the ER too often, but coordinated care can bend the curve.
01Research in Context
What this study did
Reichard et al. (2019) pulled Medicare billing records for adults with intellectual or developmental disabilities. They counted how many had long-term illnesses, ER trips, and bounce-back hospital stays within 30 days.
The team looked only at people in regular Medicare, not managed-care plans. They wanted a clear picture of health problems in this often-overlooked group.
What they found
The data showed heavy loads of chronic disease. Adults with IDD also cycled through emergency rooms far more than typical seniors.
Readmissions happened fast: many came back to the hospital within a month. The pattern screams poor care coordination.
How this fits with other research
de Leeuw et al. (2024) used newer Medicaid files and found the same thing, plus hard numbers: 39-75% of IDD sub-groups now have heart disease. Their work updates and strengthens the Medicare warning.
Faught et al. (2021) added all-payer data from New Hampshire. They showed preventable hospital stays are higher for IDD adults no matter what insurance card they carry. The trouble is not just a Medicare glitch.
Wilson et al. (2020) went a step further. They tested a cross-system care team for Medicaid members with IDD. The program cut rates of newly found high blood pressure and cholesterol, proving the problem can be tackled once it is measured.
Why it matters
If you serve adults with IDD, treat every support plan as a health plan. Ask about ER visits at each check-in. Share medication lists with primary doctors. Push for annual heart and diabetes screens. Small coordination steps can stop the revolving hospital door these papers keep showing.
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02At a glance
03Original abstract
Gaps in knowledge and systematic tracking of the prevalence of intellectual and developmental disabilities (IDD) and characteristics that may affect the health of this disability group limits our ability to address the health disparities they experience in comparison to people without disability. The purpose of this study is to begin to fill one relevant critical gap in knowledge: understanding the demographics and health outcomes of adults with IDD who receive services under Medicare Fee-for-Service (FFS), many of who are also eligible for Medicaid. Using 2016 Medicare administrative claims, we examined the prevalence and characteristics of five diagnosis groups of IDD, in those under 65 and those 65 and over, as well as their health outcomes. We found that the IDD Medicare FFS group had high prevalence rates for chronic physical and mental health conditions, overuse of emergency departments, and high rate of 30-day readmission. These findings highlight the need for evidence-based health care coordination, improved and increased public health interventions, and continued surveillance.
Intellectual and developmental disabilities, 2019 · doi:10.1352/1934-9556-57.5.405