Better care for 'dual eligibles' suggested

Jan. 10, 2012 at 10:42 PM
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WASHINGTON, Jan. 10 (UPI) -- Two U.S. researchers suggest a plan to improve care for dual eligibles -- retirees eligible for both Medicare and Medicaid.

Jane Hyatt Thorpe and Katherine Jett Hayes of George Washington University outlined a proposed state plan option where states would choose qualified health plans to provide highly integrated care services for dual eligibles.

Dual eligibles are comparatively few in number -- about 9 million nationwide -- but they account for an outsized proportion of state and federal healthcare spending: roughly $230 billion between Medicaid programs and the federal government in 2006, or 36 percent of all Medicare spending and 39 percent of Medicaid spending.

Dual-eligible beneficiaries in most cases need a minimum of three cards to navigate their benefits -- one for Medicare, one for Medicaid and one for prescriptions, the study said.

Care for this group is costly in part because they are more likely to live with chronic conditions or mental illness, and are more likely to need continuous care, the researchers said.

Care for dual eligibles is financed separately by the Medicare and Medicaid programs and coordination between the two is inconsistent, resulting in incentives to shift costs between Medicare and Medicaid, the researchers said.

"The new state plan option allows states to design a permanent program in partnership with federal officials that integrates financing and care across the Medicare and Medicaid programs to better meet the needs of dual eligibles," Thorpe said in a statement.

The paper is at www.communityplans.net.

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