Download or read book Medicare and Medicaid written by Kathryn G. Allen and published by DIANE Publishing. This book was released on 2001-04 with total page 46 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book A CRS Series on Medicaid written by and published by . This book was released on 2005 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managed Care Programs written by Momoka Ito and published by . This book was released on 2008 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A physician usually manages a healthcare organisation and is responsible for a patient's primary needs especially medical care such as physical therapy or surgery. This book provides information concerning patients' well-beings as well as the effects of health care costs and how they reflect on the quality of care of healthcare facilities.
Download or read book Examining Medicare and Medicaid Coordination for Dual eligibles written by United States. Congress. Senate. Special Committee on Aging and published by . This book was released on 2012 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Federalism and Health Policy written by Alan Weil and published by The Urban Insitute. This book was released on 2003 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.
Download or read book Dual Eligibles written by and published by . This book was released on 2002 with total page 65 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Dual Eligibles written by United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and published by . This book was released on 2012 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Experienced Voices written by and published by . This book was released on 2011 with total page 51 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2007, approximately 9 million older adults and younger people with disabilities were simultaneously covered by both Medicare and some level of Medicaid--a population commonly known as dual eligibles or duals. Dual eligibles are the poorest, sickest, and costliest of all Medicaid beneficiaries--representing 15 percent of Medicaid enrollees and 39 percent of the program's spending in 2007--with the majority of the costs going to pay for long-term services and supports not covered by Medicare. Duals are also costly to Medicare, accounting for 16 percent of the program's enrollees and more than one-quarter (27 percent) of program spending in 2006. Because of their vulnerable health status and their costs to both programs, there is considerable interest in exploring ways to deliver high-quality, coordinated services to this population, in an effort both to improve their care and rein in costs. With the federal government administering Medicare and each state administering its own Medicaid program, the delivery of health care services for duals can be fragmented and confusing. Several programs seek to address this fragmentation by offering various types and levels of care coordination for dual eligibles. In addition, the federal government is funding demonstration projects aimed at identifying new, high-quality strategies for delivering care to the dual eligible population. Missing from the discourse are the voices of dual eligibles themselves. Changes to the way their care is organized and delivered could have profound effects on their health, quality of life, and satisfaction. To address this void, the AARP Public Policy Institute (PPI) sponsored this focus group study of dual eligibles to learn more about their experiences of care across several care models. Between February and August 2011, ten focus groups were conducted in five cities with duals and, in some cases, their family members. We examined duals who were receiving care through the following models: fee-for-service Medicare and Medicaid; enhanced Primary Care Case Management (PCCM); partially integrated Medicare Special Needs plans (SNP); fully integrated Medicare Special Needs Plans; and the Program of All-Inclusive Care for the Elderly (PACE). All participants within each focus group were from the same delivery model.
Download or read book Medicare Part D CMS s Process and Policy for Enrolling New Dual Eligible beneficiaries written by and published by DIANE Publishing. This book was released on with total page 14 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Integrating Medicare and Medicaid Data to Support Improved Care for Dual Eligibles written by Lindsay Palmer Barnette and published by . This book was released on 2010 with total page 10 pages. Available in PDF, EPUB and Kindle. Book excerpt: Identifying ways to link Medicare and Medicaid data is a critical step toward integrating care for dual eligibles. Without access to Medicare data, state Medicaid agencies have only a limited picture of the dual eligible population. The availability of linked Medicare and Medicaid data can help highlight areas where integration can make a difference, such as identifying ways to reduce service fragmentation and avoidable utilization. Uncovering these opportunities can help build the case to state and federal policymakers for encouraging enrollment of additional dual eligibles into integrated care programs. This technical assistance brief provides practical information about the types of Medicare data available, how to access these data, and how to use the data to better understand the dual eligible population and uncover opportunities to improve care. The brief: * Outlines Medicare data available through the Centers for Medicare & Medicaid Services (CMS) and the Research Data Assistance Center (ResDAC); * Explains the process for obtaining Medicare data from ResDAC; * Describes the CMS Coordination of Benefits Agreement (COBA) and how it can be used to obtain Medicare claims data; * Provides an overview of how Medicare and Medicaid data can be linked; and * Examines the value of integrated data to support improvements in care for duals.
Download or read book Forum Session Announcement Medicare and Medicaid Dual Eligibles written by and published by . This book was released on with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: While the "duals" represent only 16 percent of the total Medicare population and 18 percent of the total Medicaid popula- tion, they account for almost 25 percent of total Medicare spending and 46 percent of total Medicaid spending.1 The health care status of the dually eligible population is quite diverse; many of these indi- viduals have substantial and costly medical and long-term service and s. [...] The variation in duals' health status can present challenges to providers and poli- cymakers trying to meet their needs and contain costs in both the Medicare and Medicaid programs. [...] Approximately 80 percent of the population qualifies for full Medicaid benefits, including long-term services and supports, and are often referred to as "full duals." The rest of the du- als have slightly higher incomes and qualify only for Medicaid assis- tance with Medicare premiums and cost-sharing. [...] There are duals receiving just Medicaid assistance for Medi- care premiums and cost-sharing, and there are duals receiving the full gamut of acute and long-term care services the two programs have to offer. [...] The benefits and challenges of coordinating care across Medicare and Medicaid providers, including how different program and provider incentives can affect duals' care and costs, will be dis- cussed.
Download or read book Eligibility Standards for Medicare Medicaid Dual Eligibles written by Mark Merlis and published by . This book was released on 2005 with total page 35 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicaid Coverage of Medicare Beneficiaries dual Eligibles at a Glance written by and published by . This book was released on 2009 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Supporting Integrated Care for Dual Eligibles written by and published by . This book was released on 2009 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: With the nation focused on health reform, there is an unprecedented opportunity to confront the barriers that hinder integrating care for adults who are dually eligible for Medicaid and Medicare. This policy brief, and companion resource paper, explores emerging strategies and policy options to accelerate the pace of fully integrated care.
Download or read book Recommendations to the Congress written by United States. Congress. Pepper Commission and published by . This book was released on 1990 with total page 30 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Diversity of Dual Eligible Beneficiaries written by and published by . This book was released on 2012 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nationwide, 9 million individuals are dually eligible for both Medicaid and Medicare services. These "dual eligibles" are low-income seniors and individuals with disabilities who rely on Medicare for coverage of acute care medical services (such as hospital, physician, prescription drugs, and post-acute care) and on Medicaid for financial assistance with Medicare's premiums and cost sharing. Most dual eligibles also rely on Medicaid to provide coverage for services not included in Medicare, particularly long-term care. Dual eligibles have long been of interest to policymakers due to their relatively high health care needs and correspondingly high cost: Although dual eligibles represent only 21 percent of the Medicare population and 15 percent of the Medicaid population, they account for nearly 36 percent of total Medicare spending and 39 percent of total Medicaid spending. Policymakers are exploring strategies to better coordinate and integrate care for dual eligibles and align financing for this population. Finding realistic, effective strategies is challenging for many reasons. Medicare and Medicaid are two different, very large public health insurance programs that operate separately and sometimes work at cross-purposes. Medicare is a federal program while Medicaid is a joint federal-state program that differs across states. Further, there is great diversity among dual eligibles in their health care needs. Some dual eligibles have relatively limited needs whereas others are among the nation's most vulnerable individuals with complex health conditions and high medical and long-term care costs. Despite their considerable policy importance, limited work has been done that examines combined Medicaid and Medicare service use and spending patterns for dual eligibles. In this brief, we update a previous study and present findings based on analysis of linked 2007 Medicare and Medicaid data. Specifically, we examine characteristics, health status, utilization, and spending for dual eligibles compared to the non-dual Medicare population.
Download or read book Dual Eligible Beneficiaries of Medicare and Medicaid written by Tamara Hayford and published by . This book was released on 2013-07-11 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
