Making Medicaid Work Better
August 27, 2010 - Reports & Studies
More than a million people receiving long-term services and supports are “dual eligibles” enrolled in Medicare because they are over 65 and in Medicaid because they are poor. The “dual eligibles” have been found to have higher than average medical expenses, according to chapter five in the June 2010 report, “Report to the Congress: Aligning Incentives in Medicare," by the Medicare Payment Advisory Commission.
“While they make up disproportionate shares of Medicare and Medicaid spending relative to their enrollment, neither program assumes full responsibility for coordinating all of their care,” the report said. “The Medicare and Medicaid programs often work at cross-purposes in ways that impede the coordination of care for dual-eligible beneficiaries. Conflicting program incentives encourage providers to avoid costs rather than coordinate care, and poor coordination can rise spending and lower quality. Within the dual-eligible population, there are distinct groups of beneficiaries with widely different care needs.”