Policy Options for Supporting Integrated Care for Dual Eligibles
<p>Adults who are eligible for both Medicaid and Medicare are among the nation's most chronically ill and costliest patients, accounting for close to 50 percent of all spending within Medicaid and 25 percent within Medicare. Yet, most of the nation's more than 8 million "dual eligibles" experience fragmented care as they navigate two sets of providers, benefits, and policies. </p>
<p>A new policy brief, <a href="http://www.chcs.org/publications3960/publications_show.htm?doc_id=98256… Integrated Care for Dual Eligibles</a>, addresses opportunities for integrating care for this high-cost, high-need population. Prepared by the Center for Health Care Strategies (CHCS) with support from The Commonwealth Fund, the brief outlines the benefits of integrated care and integration mechanisms, such as Special Needs Plans and "gainsharing demonstrations," where physician groups, health systems, or regional coalitions join together and use a payment system that supports integrated services. </p>
<p>"Particularly now, with the nation committed to achieving meaningful health care reform, there is an unprecedented window of opportunity for policymakers to confront the administrative, financing, and statutory barriers that hinder integrated care for dual eligibles," the authors say. </p>
<p>A <a href="http://www.chcs.org/publications3960/publications_show.htm?doc_id=98256… resource paper</a>, also available on the CHCS Web site, provides additional details on promising integrated care models. <br /></p>