Dually Eligible

On February 29, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and CHIP. As of November 2023, over 66.7 million people are enrolled in Medicare; more than 34.1 million are enrolled in fee-for-service Medicare, and over 32.6 million are enrolled in Medicare Advantage or other health plans. Over 85.8 million enrollees have Medicaid and CHIP. More than 78.7 million individuals have Medicaid and over 7.1 million have coverage through CHIP. Over 12 million individuals are dually eligible for Medicare and Medicaid and are counted in the enrollment figures for both programs.

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 Center for Health Care Strategies released a brief, funded by the Commonwealth Fund, that examined member engagement approaches used by participating health plans in Promoting Integrated Direct Care for Eligibles (PRIDE). The brief highlights promising strategies for providing Medicare-Medicaid enrollees with complex medical, behavioral health, and social service needs. There is a specific emphasis on the approaches to building trusting relationships with members.