Dual Eligibles

This new brief, made possible by The Commonwealth Fund and The SCAN Foundation, highlights insights from states that are fine-tuning their integrated care programs. Formal evaluations of some integrated care programs are underway; however, until these results become available, the refinements made by states described in the brief -- all participants in the Implementing New Systems of Integration for Dually Eligible Enrollees (INSIDE) project.

The Integrated Care Resource Center published an issue brief about the issues and options that states have when contracting with Medicare Advantage Dual Eligible Special Needs Plans.

The Department of Health and Human Services (HHS) published a report about the Minnesota Senior Health Options (MSHO) program. The Centers for Medicare and Medicaid Services (CMS) and the State of Minnesota started MSHO to coordinate the Medicare and Medicaid benefits their members receive, including Medicare coverage of acute medical care and Medicaid coverage of long-term services and supports. The report includes documentation of MSHO's outcomes from years 2010 to 2012.

Justice in Aging published an issue brief that offers an analysis of the findings from the evaluation of the Financial Alignment Initiative (FAI), commonly known as the dual eligible demonstration. Research Triangle Institute was contracted by the Centers for Medicare and Medicaid Services (CMS) to conduct this evaluation, which focused on the first six months of operation of the demonstration in each of the seven states where it was rolled out.

The Medicaid and CHIP Payment and Access Commission (MACPAC) and the Medicare Payment Advisory Commission (MedPAC) released a data book that presents information of dually-eligible beneficiaries. The information includes demographics, other personal characteristics, expenditure, and health care utilization of the dual-eligibles. This data book is the third in a series that serves to create a better understanding of this population and how they tend to use available services.

The Integrated Care Resource Center published a brief on the the implications of Medicare chronic care management services for states serving dually eligible individuals. In January 2015 a new payment system for Medicare chronic care management (CCM) became effective. This brief provides an overview of the new payment system and offers states different opportunities for more effective coordination of care with their contracting plans.

The University of California San Francisco published a report about dementia care coordination for duals populations with a specific look at the inadequate workforce of dementia-capable care coordinators.Currently, there are twelve states in the process of implementing demonstrations projects. This report examined three-way contracts from seven states that were selected for their expertise in care coordination.