Liberal groups highlight Medicare, Medicaid 'dual eligibles'

Liberal groups issued policy recommendations Monday morning on how to manage care for a typically costly population of so-called “dual eligibles” — people who qualify for both Medicare and Medicaid.

Because of generally poorer health and greater needs for high-cost services, the country's 8.8 million dual eligibles are the most expensive population within the Medicare and Medicaid programs and the most difficult to coordinate care for, according to a report issued Monday morning by the Center for American Progress and Community Catalyst.

According to the report, dual eligibles make up 18 percent of Medicaid enrollees but consume 46 percent of program spending. Meanwhile, they comprise 16 percent of Medicare enrollees but consume 25 percent of spending.

The healthcare reform law includes a number of provisions aimed at improving care coordination for dual eligibles, including a new Federal Coordinated Health Care Office within the Centers for Medicare and Medicaid Services. The new Center for Medicare and Medicaid Innovation at CMS, which will test payment and service delivery models, will benefit dual eligibles, the groups said.

The policy paper calls on the federal government and states to pursue new opportunities for managing dual eligibles that focus on five principles: start with a well-designed healthcare delivery system; ensure strong beneficiary protections; engage dual eligibles and their families in program design; ensure combined Medicare/Medicaid funds to enhance healthcare delivery; and establish a culture of quality improvement.