All Articles In 'Tag Archives: 'Dual Eligibles''
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
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
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
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 [...]
Chronic Care Management: Technologies to Better Manage Chronic Conditions
The nation’s largest health care buyers – Medicare, state Medicaid programs, large employers, and health plans – are eager for ways to improve the quality and efficiency of chronic health conditions, which drive the bulk of [...]
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 [...]
Payment Reform Models: Coordinated Primary Care for Employees
Coordinated primary care models have shown great potential to reduce health care costs while improving care, a goal that will become even more important after the Affordable Care Act (ACA) coverage expansion provisions take full effect [...]
Medicare Drug Benefit: Formulary Oversight in Medicare Part D
Medicare Part D, the Medicare drug benefit, served roughly 31 million seniors last year. Medicare Part D is more similar to Medicare Advantage than to traditional Medicare in that enrollees can choose among several private health [...]
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
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 [...]
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