All Articles In 'Dual Eligibles'

Medicare Special Needs Plans: MedPAC Recommendations on Future of Special Needs Plans

Medicare Special Needs Plans: MedPAC Recommendations on Future of Special Needs Plans

Special Needs Plans (SNP) are part of the Medicare Advantage program and were created by the Medicare Modernization Act of 2003 (MMA). There are three types of SNPs, each intended to provide coordinated care for Medicare [...]

Medicare and Medicaid Spending on Dual Eligible Populations: Analysis of Health Costs

Medicare and Medicaid Spending on Dual Eligible Populations: Analysis of Health Costs

Much of the story about rising health costs and spending has to do with relatively small groups of people with expensive health needs. For example, the Centers for Medicare and Medicaid Services (CMS) estimates Medicare beneficiaries [...]

Dual Eligibles and Medicare Cost Sharing: State Medicaid Payment of Medicare Premiums, Deductibles, and Co-Payments

Dual Eligibles and Medicare Cost Sharing: State Medicaid Payment of Medicare Premiums, Deductibles, and Co-Payments

State Medicaid programs will spend about $175 billion this year on health care for dual eligibles – low-income seniors and persons with disabilities who receive benefits from both Medicare and Medicaid.  State spending on dual eligibles [...]

Chronic Care Management: CMS Multiple Chronic Conditions Dashboard

Chronic Care Management: CMS Multiple Chronic Conditions Dashboard

Many new care models in both the public and private sector focus on people with chronic diseases, particularly conditions like diabetes, congestive heart failure, and hypertension. The Veterans Health Administration (VHA) Care Coordination/Home Telehealth (CCHT) pilot program [...]

Medicare-Medicaid Dual Eligibles: Measuring Quality of Special Needs Plans and State Demonstrations

Medicare-Medicaid Dual Eligibles: Measuring Quality of Special Needs Plans and State Demonstrations

Medicare-Medicaid dual eligibles are often held up as a prime case for the need for better care management to reduce health costs and spending while improving quality.  But doing so can be challenging.  Most dual eligibles [...]

Medicaid Reform: Lessons from Medicaid Payment and Delivery Reforms in Three States

Medicaid Reform: Lessons from Medicaid Payment and Delivery Reforms in Three States

Today, Medicaid spends nearly $500 billion a year on health care for about 71 million Americans.  Responsible for a quarter of state budgets, the highly complex program is poised to grow dramatically under the Affordable Care [...]

5 Causes of Wasteful Health Care Spending

5 Causes of Wasteful Health Care Spending

A painful fact about the U.S. health system is that roughly one third of health costs and spending are wasted. A study in the Journal of the American Medical Association (JAMA) found that wasted health spending [...]

The Promise of Telehealth: Three Case Studies of Early Adopters

The Promise of Telehealth: Three Case Studies of Early Adopters

Much of the health information technology (HIT) today promotes patient communication to improve care and potentially lower costs. Some examples are interactive preventive health records (IPHR), e-prescribing, and electronic health records (EHR). Emerging telehealth technologies, however, [...]

Integrated Care for Medicare-Medicaid Dual Eligibles: CMS Grants for Implementation of State Demonstrations

Integrated Care for Medicare-Medicaid Dual Eligibles: CMS Grants for Implementation of State Demonstrations

To support demonstrations to integrate Medicare and Medicaid for dual eligibles, the Centers for Medicare and Medicaid Services (CMS) offering state Medicaid agencies grants of up to $15 million each.  The funds are for implementation of [...]

Seven Ideas to Reduce Costs and Improve Outcomes in Medicare and Medicaid

Seven Ideas to Reduce Costs and Improve Outcomes in Medicare and Medicaid

Medicare and Medicaid spending will exceed $1 trillion in FY 2013.  Together, the two programs now serve about 113 million Americans – over a third of the population.  Policymakers in Washington and the states face a daunting [...]