« The Dual Agenda: January 21, 2015 Issue

Featured Resources

Updated Data Book on Dual Eligibles

The Medicaid and CHIP Payment and Access Commission (MACPAC) and the Medicare Payment Advisory Commission (MedPAC) released the second edition of their joint data book, Beneficiaries Dually Eligible for Medicare and Medicaid. The data presented is from 2010 and includes information on dual eligible demographics, spending and health trends and has a chapter on Medicare and Medicaid spending for dual eligible beneficiaries by category of LTSS service use.

Webinar Materials: Health Plan Approaches to Locating New Medicare-Medicaid Enrollees and Building Trusting Relationships 

The Center for Health Care Strategies (CHCS), with support from The Commonwealth Fund, hosted a webinar on health plan strategies for contacting hard-to-locate Medicare-Medicaid enrollees, building relationships, and creating person-centered care plans that incorporate social service and housing needs. Speakers include representatives from two plans participating in PRIDE (Promoting Integrated Care for Dual Eligibles). Recording of the webinar is available here.

New Brief on Integrated Appeals Process for Dual Eligibles

A recent policy brief by the Center for Health Care Strategies explores opportunities for states to develop an integrated appeals process, either through a Dual Eligible Special Needs Plan (D-SNP) or a financial alignment demonstration. It presents lessons from Minnesota's D-SNP-based Senior Health Options program and the Health Plan of San Mateo on aligning appeals processes, coverage determinations and provider payments at the health plan level. It also includes early insights from New York's newly launched Fully Integrated Duals Advantage program.