Dual Eligibles

What strategies addresses the growth in Medicare and Medicaid spending by improving the coordination of care and reducing the cost for those who are dually eligible for both programs? This report evaluated plans such as PACE, Minnesota Senior Health Options, the Wisconsin Partnership Program and Evercare, which showed a reduction of hospitalizations. PACE was included as part of the solution to controlling Medicare and Medicaid spending.

Review recordings and handout materials from the National Association of Medicaid Directors Fall 2012 conference. Topics include Medicaid innovations, community integration, access to care, Medicaid long term services and supports, and dual eligible integration, and much more.

This report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. It provides national-level summary tables relating to trends, breakout of managed care entities, managed care enrollment by state, regional breakout and states with comprehensive health care reform demonstrations. The information was collected from State Medicaid agencies and CMS Regional Offices.

This report details development of the Agency for Healthcare Research and Quality (AHRQ)’s Quality Indicators (QI) for the HCBS population. It includes key sections: 1) the introduction section providing background on the HCBS QI development project. 2) the methods section on an overview of the QI development process, 3) results of details of empirical analyses performed to support QI, 4) the concluding thoughts section providing a discussion of interpretation of the indicators.

This poster describes the use of a propensity score matching methodology to identify comparison groups among Medicare-Medicaid beneficiaries who received Medicaid-paid LTSS via HCBS waivers versus those who did not receive LTSS. This matching technique was used to establish comparable treatment/control pairs for subsequent analysis of cross-payer effects of providing Medicaid-paid LTSS on Medicare acute care resource use, and could be used more generally to strengthen policy analyses.

The purpose of this literature review is to better understand the various pathways to Medicare-Medicaid eligibility, how and why and individual becomes eligible for both programs. Also, this report presents examples of federal government- and state-sponsored programs and supports aimed at delaying or preventing a descent into functional decline and/or poverty. The ways to simplify the enrollment process for those who quality and need Medicare and Medicaid benefits are discussed as well.

This paper discusses the progress states have made in moving away from institutional care for Long-Term Supports and Services and toward home and community-based programs. It analyzes the opportunities available through the Affordable Care Act and other programs whereby states can continue that progress even in a challenging budget environment.

This study focuses on new Medicare-Medicaid enrollees in Maryland and the circumstances that shaped their initial eligibility for both programs. This report details the demographic and programmatic characteristics of new enrollees. Specifically, it serves as the vehicle for establishing an initial operational definition of new enrollees and developing the terminology needed to describe the circumstances surrounding initial Medicare-Medicaid eligibility.

This report describes and analyzes chronic disease patterns and health care expenditures of persons in Maryland who in 2008 began to receive coverage from both Medicare and Medicaid. The analysis focuses on disease and expenditure patterns in the year before these individuals, most of whom had been enrolled in Medicare alone or Medicaid alone, became enrollees in both programs. The results can provide a better understanding of simultaneous enrollment in Medicare and Medicaid.

This survey reports on trends in Medicaid spending, enrollment and policy initiatives for FY 2012 and FY 2013. The report describes policy changes in reimbursement, eligibility, benefits, delivery systems and long-term care, as well as detailed appendices with state-by-state information, and a more in-depth look through four state-specific case studies of the Medicaid budget and policy decisions in Massachusetts, Ohio, Oregon and Texas.