“Better Care For People Dually Eligible For Medicare And Medicaid,” by Seema Verma, Health Affairs Blog
“Twelve million Americans are simultaneously enrolled in both Medicaid and Medicare, relying on the state and federal governments to separately administer different aspects of their health coverage. These dually eligible individuals experience high rates of chronic illness, with many having multiple chronic conditions and social risk factors. Forty-one percent of dually eligible individuals have at least one mental health diagnosis, and about half use long-term services and supports (LTSS). Medicare and Medicaid were originally created as distinct programs with different purposes and have operated as separate systems despite a growing number of people who depend on both. This lack of coordination can lead to fragmented care for individuals, misaligned incentives for payers and providers, and administrative inefficiencies and programmatic burdens for all. … We must do better, and CMS is taking action. We are building from four pillars:
- Seamless experiences for beneficiaries across programs
- Resolution of misalignments between programs
- Incentives for cost efficiency and quality improvement
- Accountability for outcomes”
LTC Comment (from Stephen A. Moses, President, Center for Long-Term Care Reform):
All well and good, but it would be far better to also reduce the number of dual eligibles in the future by addressing the cause that created so many of them today. For how to do that, see Briefing Paper #5: Dual Eligibles and Long-Term Care: How to Save Medicaid LTC $30 Billion Per Year www.centerltc.com/BriefingPapers/5.htm — (PDF for print)
