The 9 million beneficiaries dually eligible for Medicare and Medicaid are generally poorer and sicker than other Medicare beneficiaries, tend to use more health care services, and thus account for a disproportionate share of spending in both programs. Many deficit reduction plans under recent discussion have recognized the need to improve care for this population and provide care in a more cost-effective way.
Dual eligibles present a special challenge for those seeking a more efficient and coordinated care delivery system. As integrated care models expand, consumer protections may be needed to assure choice and access to current providers and culturally appropriate services.
How do Medicaid and Medicare coordinate payment and care for people covered by both programs? Are HHS initiatives encouraging innovations to integrate care for dual eligible beneficiaries? What kinds of programs are currently available? What do consumers think about fee-for-service plans, special needs plans or other programs in which they are currently enrolled? What lessons for program design can policy makers learn from the attitudes of consumers?
To answer these and related questions, the Alliance for Health Reform and the AARP Public Policy Institute sponsored a December 12 briefing. Panelists were: Lindsay Barnette, Medicare-Medicaid Coordination Office at CMS; Lynda Flowers, AARP Public Policy Institute; Suzanne Gore, Center for Health Care Strategies; and Corrinne Altman Moore, Office of Medicaid, Massachusetts Executive Office of Health and Human Services. Susan Reinhard of AARP and Ed Howard of the Alliance co-moderated.
This briefing presented the results of two recent focus group studies that shed light on the experience of dual eligibles, which programs they prefer and how they and other stakeholders might be engaged in the program design process.
Full Transcript (Adobe Acrobat PDF)