Dual Eligibles

Posted June 15, 2012
Dual eligibles across all age groups have high rates of both chronic conditions and functional impairment and may require both medical services and LTSS to meet their care needs. Experts agree that the coordination of medical care and LTSS could help improve duals’ quality of life and reduce expenditures for Medicare and Medicaid. However, this population is very diverse. For example, younger duals with functional impairment and chronic conditions may have signifcantly different preferences for how they receive LTSS than seniors.
Posted December 4, 2011
Aging safely and independently at home is a strongly held desire among most Americans, and the U.S. Supreme Court’s Olmstead decision requires public programs to honor these desires when feasible. This policy brief reports on in-depth interviews conducted over a period of one year concerning 33 older adults who receive noninstitutional long-term care services and supports (LTSS).This policy brief documents the challenges experienced by this typical group of California seniors, who have been struggling with cuts to the state services they receive.
Posted November 15, 2011
A new body of research will be needed to help federal and state policy makers identify methods for improving the quality and efficiency of care for individuals with long-term services and supports (LTSS) needs enrolled in Medicaid only and in both Medicaid and Medicare for dual eligibles. Such research can benefit from Medicaid’s and Medicare’s administrative data to evaluate services provided to individuals by need and along the entire care continuum. To be useful to policy-makers, research must be comprehensive, scientifically valid, and timely.
Posted November 13, 2011
This paper provides recommendations on changes to improve delivery of the Qualified Medicare Beneficiary (QMB) program so that it can more fully serve the purposes for which the program was established. It is the last in a series of four papers that highlight pressing issues facing dual eligibles and provide recommendations to the federal Medicare-Medicaid Coordination Office (MMCO), state Medicaid agencies and other interested policymakers and stakeholders on how to address them.
Posted October 4, 2011
This paper provides recommendations for building an integrated appeals process for individuals that qualify for Medicare and Medicaid (dual eligibles). It is the third in a series of four papers that highlight pressing issues facing dual eligibles and provide recommendations to the Medicare-Medicaid Coordination Office (MMCO), state Medicaid agencies and other interested policymakers and stakeholders on how to address them. The first paper addressed consumer protections needed in delivery system models that integrate Medicare and Medicaid.
Posted August 22, 2011
This paper about differences in Medicare Medicaid program rules and coverage standards is the second in a series of four papers that highlight pressing issues facing dual eligibles and provide recommendations to the Medicare-Medicaid Coordination Office (MMCO), state Medicaid agencies and other interested policymakers and stakeholders on how to address them. The first paper addressed consumer protections needed in delivery system models that integrate Medicare and Medicaid.
Posted July 12, 2011
This paper is the first in a series of four papers designed to highlight pressing issues facing dual eligibles and provide recommendations to the Medicare-Medicaid Coordination Office, state Medicaid agencies and other interested policymakers and stakeholders on how to address them. This first paper provides recommendations for consumer protections in delivery system models that integrate Medicare and Medicaid.
Posted January 30, 2011
Low-income older adults with disabilities in California depend on a variety of public programs to help them remain in their own homes. This policy note provides the first findings from a study that is following a group of California seniors who depend on fragile arrangements of paid and unpaid help to maintain their independence. The analysis finds that the disability needs of these older adults are often unstable, with both their physical and mental health status sometimes changing day to day.