Dual Eligibles

Posted July 19, 2013
Across the country state Medicaid agencies are partnering with the federal government to build new approaches to integrated care for Medicare-Medicaid enrollees (also known as “dual eligibles”). Leading this activity is the Medicare & Medicaid Coordination Office, which is charged with improving care for this population through new capitated or managed fee-for-service models that integrate financing and service delivery.
Posted May 28, 2013
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Posted May 16, 2013
State Medicaid programs are increasingly exploring ways to provide long-term services and supports (LTSS) through capitated managed care plans rather than traditional fee-for-service delivery systems. Over half of the states in the country are expected to be operating managed long-term services and supports (MLTSS) programs by January 2014. MLTSS is also an important component of several states' demonstration programs to integrate care for individuals dually enrolled in Medicare and Medicaid.
Posted April 30, 2013
Cal MediConnect is California's pilot program seeking to coordinate care for seniors who are eligible for both Medicare and Medicaid.  Cal MediConnect is part of the state's Coordinated Care Initiative (CCI).
Posted April 10, 2013
Low-income older adults and people with disabilities who are eligible for both the Medicare and Medicaid programs are often called “dual eligibles.” Medicare is the federal health insurance program for persons age 65 and over. Medicaid, funded by the federal and state governments, covers health services and long-term services and supports (LTSS) for millions of low-income Americans.
Posted April 10, 2013
Cal MediConnect is the state of California's dual eligible demonstration pilot, to coordinate care for individuals eligible for both Medicare and Medicaid.  It is part of the state's Coordinated Care Initiative (CCI).
Posted March 5, 2013
More than 9 million Americans are enrolled in both the Medicare and Medicaid programs. Often, the care provided to these beneficiaries is fragmented and there is misalignment of administrative, regulatory, statutory and financing systems. Health care costs for people with Medicare and Medicaid are twice as high as for people with Medicare alone. In the Medicaid system, these costs also are greater than for the average Medicaid beneficiary, primarily because of spending for long-term services and supports.
Posted February 14, 2013
The passage of the Affordable Care Act (ACA) in 2010 created the Medicare-Medicaid Coordination Office (MMCO) in the Centers for Medicare & Medicaid Services (CMS), establishing unparalleled potential to improve care for individuals who are dually eligible for Medicare and Medicaid. MMCO has since released two opportunities, the State Demonstrations to Integrate Care for Dual Eligible Individuals and the Financial Alignment Demonstration, for states and the federal government to work together to improve coordination and alignment of care for Medicare-Medicaid enrollees.
Posted February 11, 2013
California is one of fifteen states that received a $1 million design contract from the Centers forMedicare and Medicaid Services (CMS) to develop plans to better integrate the financing and services of Medi-Cal (California’s Medicaid program) and Medicare for those dually eligible for both programs (often referred to as dual eligibles or Medicare-Medicaid enrollees, MMEs). The state’s efforts resulted in the passage of the Coordinated Care Initiative (CCI), authorizing a three-year demonstration beginning in 2013.
Posted January 7, 2013
States, with the support of the Centers for Medicare & Medicaid Services (CMS), are working toward improving the integration of care for individuals dually eligible for both Medicare and Medicaid (known as Medicare-Medicaid enrollees or “dual eligibles”). They face several challenges in demonstrating how these new models improve the care provided, including complex methodological issues around appropriate comparison groups and time periods, the need to access data, and the lack of baseline quality measures pertinent to dual eligibles.