Dual Eligibles

In this blog post, ACAP and CHCS share survey results that detail how Community Affiliated Plans (ACAP), including Dual Eligible Special Needs Plan (D-SNP) and Medicare-Medicaid Plans, are addressing existing and new health-related social needs of their dually eligible enrollees during the COVID-19.

CMS recently provided an update to the 2021 SSI and Spousal Impoverishment Standards. Spousal impoverishment standards are adjusted in January to reflect changes in the Supplemental Security Income (SSI) federal benefit rate (FBR) and the Consumer Price Index (CPI). These new standards will become effective on January 1, 2021.

ACL and the Lewin Group released a report highlighting key takeaways from the AARP 2020 LTSS State Scorecard on state efforts in establishing high-performing ADRC/NWD systems. The report compares current data with results from the 2017 LTSS State Scorecard. The report provides scores based on five domains in ADRC/NWD system functions. The report also shares promising practices/lessons learned from five states – Alabama, Georgia, Massachusetts, Ohio, and South Dakota.

This resource aims to help human service agencies in states, tribes, and territories to measure their progress in developing person-centered systems. The Self-Assessment was designed to be used by staff at all levels. The Self-Assessment measures progress in eight different domains: Leadership; Person-Centered Culture; Eligibility & Service Access; Person-Centered Service Planning & Monitoring; Finance; Workforce Capacity and Capabilities; Collaboration & Partnership; and Quality & Innovation

ATI Advisory released extensive data analysis of Medicare claims data to highlight the disparate impact of the COVID-19 pandemic on individuals eligible for both Medicare and Medicaid (dual eligibles).The analysis also offers policy pathways for states to improve integrated care for this vulnerable population.

CHCS and Speire Healthcare Strategies released a report about COVID-19 response efforts from states and health plans that offer integrated care programs for duals. People who are dually eligible for Medicare and Medicaid are among the nation’s most vulnerable to the coronavirus. The report outlines opportunities to support integration and identifies opportunities to strengthen programs and policies to best support the dual eligible population during the pandemic and in the future.

This issue brief from the MLTSS Institute focuses on aspects of delivering effective care to individuals eligible for both Medicare and Medicaid (dually eligible individuals).The brief provides a primer on the ways that Medicare data can help states better deliver care to dually eligible individuals; it also details information about data sources and other resources available to help obtain and analyze Medicare data.

NGA recently published a policy memo including a detailed table that provides an overview of state actions to address COVID-19 in long-term care facilities. The table includes notable actions from states with helpful links to relevant guidance and resources for each state. Updates on additional state actions and examples will be added to the table regularly and states are encouraged to contact NGA with changes.

Justice in Aging published a new brief centered on the dual eligible population and programmatic recommendations to support equity. The recommendations are measures advocates and health plans can use to ensure equity is at the center of the response to COVID-19. Examples of recommendations in the brief include: Expanding/targeting outreach for COVID-19 and routine care based on information plans have about their members; Prioritizing HCBS and support for caregivers; Enhancing data collection

This brief draws from interviews with states operating new and long-standing MLTSS programs to identify six major trends in the refinement of MLTSS and underlying LTSS delivery systems nationally. The states examined in this brief are strengthening their Medicaid MLTSS programs to serve more LTSS beneficiaries and facilitate the development of integrated care programs that reduce service fragmentation for Medicare-Medicaid enrollees, particularly through Medicare Advantage D-SNPs