States trying managed care for 'dual eligibles' - Medicare/Medicaid recipients

Published on December 7, 2012 at 5:45 AM · No Comments

People who qualify for Medicare and Medicaid - many of whom are elderly and in nursing homes - need lots of often-expensive care.

Kaiser Health News: Huge Experiment Aims To Save On Care For Poorest, Sickest Patients
Twenty-five states have applied to be part of the managed care experiment for so-called "dual-eligibles," people who qualify for both Medicare and Medicaid. All dual-eligibles are poor ... Patient advocates around the country, and some lawmakers in Congress, warn that managed care plans – some run by for-profit, publicly traded companies – are ill-equipped to deal with the complex health needs of those who are elderly, mentally ill or disabled (Carey and Varney, 12/6).

California Healthline: Duals Project Edges Closer To Completion
More than 300 people attended a Department of Health Care Services seminar yesterday offering details of the duals demonstration project, also known as the Coordinated Care Initiative. The department recently released several reports, including a draft of the care coordination and long-term services and supports readiness standards. … The number of dual-eligibles in the demonstration project is now estimated to be 525,000 -- significantly fewer than the original estimate of about 700,000 (Gorn, 12/6).

CQ HealthBeat: Groups Forming Consortium Of Plans That Cover Dually Eligible Beneficiaries
States that are testing out ways to shift dually eligible patients into managed care could get some guidance from a new consortium of health plans being put together by the Visiting Nurse Service of New York with support from The Commonwealth Fund. The project, known as Promoting Integrated Care for Dual Eligibles, was mentioned in a presentation at a conference in Washington sponsored by the National Committee for Quality Assurance on Tuesday (Adams, 12/5).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

 

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