Dual Eligibles

The Association for Community Affiliated Plans (ACAP) and Community Catalyst released an issue brief regarding the Financial Alignment Demonstrations. This issue brief discusses key findings from research on the demonstrations and proposes recommendations in two areas: operational or practice changes for health plans and program adjustments for policymakers.

The Center for Health Care Strategies (CHCS) published their report, “ACAP Medicare-Medicaid Plans and the Financial Alignment Demonstrations: Innovations and Lessons”, that was prepared for the Association for Community Affiliated Plans (ACAP). The report examines the experiences of 14 ACAP plans that are participating in capitated model demonstrations for the Centers for Medicare & Medicaid (CMS) Financial Alignment Initiative.

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 Bipartisan Policy Center (BPC), with funding from the SCAN Foundation, published a report offering recommendations to improve the financing of long-term care. The BPC published another report in April 2014 that examined the challenges in financing and delivery. This report is a follow up of those findings that offers recommendations to improve these issues.

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 Centers for Medicare & Medicaid Services (CMS) began the Financial Alignment Demonstration in 2013 to improve care coordination. GAO was asked to examine care coordination under this demonstration. On January 19, The Government Accountability Office publicly released a report with their recommendations for CMS. GAO recommends that CMS develop new measures and align the current measures to improve oversight of care coordination.

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.

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.

This is the official White House Conference on Aging (WHCOA) Toolkit that organizations and individuals can use to host their own events and submit to the official 2015 White House Conference. The four focus areas of the 2015 WHCOA include retirement security, healthy aging, long-term services and supports, and elder justice.