Dual Eligibles

To understand both the needs of people who use long-term services and supports (LTSS) through Medicare and Medicaid coverage and ways to apply quality measurement to this population, the National Committee for Quality Assurance (NCQA), supported by The SCAN Foundation, developed a roadmap for evaluating the quality of integrated care for dual eligibles.

The CMS Medicare-Medicaid Coordination Office (MMCO) regularly reports data on Medicare-Medicaid enrollee demographics, service utilization, spending, and other characteristics that can give states a more comprehensive view of this population. This tool shows states how to use these data to create tables, graphs, and figures and interpret their meaning for a wider audience of stakeholders.

This brief from the SCAN Foundation summarizes lessons learned and offers recommendations for improving integrated systems of care for people with Medicare and Medicaid, also known as dually eligible individuals. The brief draws from three years of California’s Cal MediConnect evaluation results.