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Author: Tamara Hayford
Publisher:
ISBN: 9781457846786
Category :
Languages : en
Pages : 45
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Book Description
In 2009, the federal and state governments spent a total of more than $250 billion on health care benefits for the 9 million low-income elderly or disabled people who are jointly enrolled in Medicare and Medicaid. Those eligible to receive benefits from both programs at the same time are “dual-eligible beneficiaries.†All of those beneficiaries qualify for full Medicare benefits, but they differ in the amount of Medicaid benefits for which they are eligible. Seven million are “full duals,†who qualify for full benefits from both programs. The other 2 million are “partial duals,†who do not meet the eligibility requirements for full Medicaid benefits but qualify to have Medicaid pay some of the costs they incur under Medicare. This report examines the characteristics and costs of dual-eligible beneficiaries, focusing on 2009. It also examines the different payment systems that Medicare and Medicaid use to fund care for dual-eligible beneficiaries and recent efforts at the federal and state levels to integrate those payment systems and to coordinate the care that such beneficiaries receive from the two programs. Figures and tables. This is a print on demand report.
Author: Tamara Hayford
Publisher:
ISBN: 9781457846786
Category :
Languages : en
Pages : 45
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Book Description
In 2009, the federal and state governments spent a total of more than $250 billion on health care benefits for the 9 million low-income elderly or disabled people who are jointly enrolled in Medicare and Medicaid. Those eligible to receive benefits from both programs at the same time are “dual-eligible beneficiaries.†All of those beneficiaries qualify for full Medicare benefits, but they differ in the amount of Medicaid benefits for which they are eligible. Seven million are “full duals,†who qualify for full benefits from both programs. The other 2 million are “partial duals,†who do not meet the eligibility requirements for full Medicaid benefits but qualify to have Medicaid pay some of the costs they incur under Medicare. This report examines the characteristics and costs of dual-eligible beneficiaries, focusing on 2009. It also examines the different payment systems that Medicare and Medicaid use to fund care for dual-eligible beneficiaries and recent efforts at the federal and state levels to integrate those payment systems and to coordinate the care that such beneficiaries receive from the two programs. Figures and tables. This is a print on demand report.
Author: Jules Mauthner
Publisher: Nova Science Publishers
ISBN: 9781628087314
Category : Managed care plans (Medical care)
Languages : en
Pages : 0
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Book Description
Medicare is a federal program that provides health insurance coverage to people who have disabilities, are diagnosed with certain medical conditions, or are age 65 or older. Medicaid, which is funded jointly by the federal government and the states, provides health care coverage to low-income people who meet specific requirements for income and assets and other eligibility criteria. People who are eligible to receive benefits from both programs at the same time are known as dual-eligible beneficiaries'. This book examines the characteristics and costs of dual-eligible beneficiaries, focusing on 2009, the most recent year for which comprehensive data were available when the Congressional Budget Office (CBO) began this analysis.
Author: Kathryn G. Allen
Publisher: DIANE Publishing
ISBN: 9780756709006
Category :
Languages : en
Pages : 46
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Book Description
States have been seeking federal waivers since the early 1990s to use managed care approaches to integrate the delivery of acute & long-term-care services for certain dual eligiblesÓ -- low-income Medicare beneficiaries who also quality for full Medicaid benefits. Dual eligibles often receive their Medicare & Medicaid benefits from two different sets of providers. This report determines: (1) the status & key features of state initiatives to integrate care for dual-eligible beneficiaries; & (2) factors that have contributed to the length of the waiver negotiation process & implementation time frames.
Author: United States. Congress. Senate. Special Committee on Aging
Publisher:
ISBN:
Category : Elderly poor
Languages : en
Pages : 128
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Book Description
Author: U.s. Government Accountability Office
Publisher: Createspace Independent Publishing Platform
ISBN: 9781974198665
Category :
Languages : en
Pages : 74
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Book Description
" Dual-eligible beneficiaries are low-income seniors and individuals with disabilities enrolled in Medicare and Medicaid. In 2010, there were about 9.9 million dual-eligible beneficiaries. Both programs have requirements to protect the rights of beneficiaries. These requirements are particularly important to dual-eligible beneficiaries, who must navigate the rules of both programs and generally have poorer health status. To help inform efforts to better integrate the financing and care for dual-eligible beneficiaries, GAO (1) compared selected consumer protection requirements within Medicare FFS and Medicare Advantage, and Medicaid FFS and managed care, and (2) described related compliance and enforcement actions taken by CMS and selected states against managed care plans. GAO identified consumer protections of particular importance to dual-eligible beneficiaries on the basis of expert interviews and literature, including protections related to enrollment, provider networks, and appeals. GAO reviewed relevant federal and state statutes, regulations, and policy statements, and interviewed officials from CMS and four states selected on the basis of their share of dual-eligible beneficiaries and use of managed care (Arizona, California, Minnesota, and North Carolina). GAO analyzed data on compliance and enforcement actions in Medicare Advantage and Medicaid managed care from"
Author: United States. Congress. Pepper Commission
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 30
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Book Description
Author: United States Government Accountability Office
Publisher: Createspace Independent Publishing Platform
ISBN: 9781976386305
Category :
Languages : en
Pages : 72
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Book Description
Since January 1, 2006, all dual-eligible beneficiaries-individuals with both Medicare and Medicaid coverage-must receive their drug benefit through Medicare's new Part D prescription drug plans (PDP) rather than from state Medicaid programs. GAO analyzed (1) current challenges in identifying and enrolling new dual-eligible beneficiaries in PDPs, (2) the Centers for Medicare & Medicaid Services' (CMS) efforts to address challenges, and (3) federal and state approaches to assigning dual-eligible beneficiaries to PDPs. GAO reviewed federal law, CMS regulations and guidance and interviewed CMS and PDP officials, among others. GAO also made site visits to six states to learn about the enrollment of dual-eligible beneficiaries from the state perspective.
Author: James Cosgrove
Publisher:
ISBN: 9781457858147
Category :
Languages : en
Pages : 44
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Book Description
In 2009, the Medicare and Medicaid programs spent an estimated $103 billion on disabled dual-eligible beneficiaries -- those individuals who are disabled, under age 65, and qualify for both Medicare and Medicaid benefits. Recently, Congress and the Centers for Medicare & Medicaid Services (CMS) have emphasized benefit integration for all dual-eligible beneficiaries -- both disabled and aged -- including beginning a financial alignment demonstration, which CMS expects will improve care and reduce program spending. This report examined (1) spending, utilization, and health status patterns for the portion of this population with the highest spending; (2) the extent to which integrated dual-eligible special needs plans (D-SNPs) provided high quality of care for this population while controlling Medicare spending; and (3) D-SNPs' and traditional Medicare Advantage (MA) plans' performance in serving this population based on quality and resource use measures. Tables and figures.
Author:
Publisher: DIANE Publishing
ISBN: 9781422396643
Category :
Languages : en
Pages : 14
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Book Description
Author: United States Government Accountability Office
Publisher: Createspace Independent Publishing Platform
ISBN: 9781982005726
Category :
Languages : en
Pages : 44
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Book Description
Disabled Dual-Eligible Beneficiaries: Integration of Medicare and Medicaid Benefits May Not Lead to Expected Medicare Savings
