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About 9 million people in the United States are covered by both Medicare and Medicaid, including low-income seniors and younger people with disabilities. These dual eligible beneficiaries have complex and often costly health care needs, and have been the focus of many recent initiatives and proposals to improve the coordination of their care aimed at both raising the quality of their care while reducing its costs. This page highlights some key resources examining the dual eligible population and provides you with the standard search result page for a site-wide search on the dual eligible tag.

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The Henry J. Kaiser Family Foundation

Medicare Part D 2010 Data Spotlight: The Coverage Gap

This data spotlight examines the coverage gap, or “doughnut hole,” in Medicare stand-alone drug plans available in 2010. While in the gap in coverage, Part D enrollees (other than those receiving low-income subsidies) are required to pay 100 percent of total drug costs until they reach the catastrophic coverage level.…

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The Henry J. Kaiser Family Foundation

Financial Alignment Models for Dual Eligibles: An Update

The nearly nine million dual eligibles who receive both Medicare and Medicaid benefits are a high cost, high need population, accounting for a disproportionate share of expenditures relative to their enrollment in both programs. In April 2011, the Centers for Medicare and Medicaid Services (CMS) announced the award of design…

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The Henry J. Kaiser Family Foundation

Among Dual Eligibles, Identifying The Highest Cost Individuals Could Help In Crafting More Targeted And Effective Responses

This Health Affairs article by researchers at the Urban Institute analyzes linked Medicare and Medicaid data to examine dual eligibles’ utilization and spending in both programs in 2007. It finds that while the population of people dually eligible for Medicare and Medicaid is indeed costly, it is not monolithic. For…

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The Henry J. Kaiser Family Foundation

Articles Examine Data and Issues For Expanding Integrated Care Models For Dual-Eligible Beneficiaries

As state and federal policymakers move to develop and test integrated care models for people dually eligible for Medicare and Medicaid, two new Kaiser Family Foundation articles in the June 2012 issue of Health Affairs highlight the diverse needs and challenges facing these 9 million beneficiaries, describe their current care…

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The Henry J. Kaiser Family Foundation

The Role of National Firms in Medicare+Choice

This report addresses national managed care firms participation in M+C and the factors influencing their decision processes about M+C products. Based on interviews with executives and senior staff of national managed care firms, this report examines how eight national firms strategically position their M+C product, including the process that firms…

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The Henry J. Kaiser Family Foundation

Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries…

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The Henry J. Kaiser Family Foundation

State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS

The Centers for Medicare and Medicaid Services (CMS) has proposed two models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries, one capitated model and one managed fee-for-service model. In the spring of 2012, 26 states submitted proposals to CMS seeking to test one or both of…

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The Henry J. Kaiser Family Foundation

Increasing Medicaid Payments for Certain Primary Care Physicians in 2013 and 2014: A Primer on the Health Reform Provision and Final Rule

To help ensure that access in Medicaid expands to meet anticipated higher demand for care, the health reform law requires states to pay certain physicians Medicaid fees that are at least equal to Medicare’s for a list of 146 primary care services in 2013 and 2014. The idea is to…

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The Henry J. Kaiser Family Foundation

A Prescription Drug Benefit in Medicare: Implications for Medicaid and Low-Income Medicare Beneficiaries

The Senate and House of Representatives each approved legislation in June of 2003 that would establish outpatient prescription drug coverage for Medicare beneficiaries as part of Medicare program reform. Among the key differences in the House and Senate bills that still must be addressed are the treatment of Medicaid beneficiaries…

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The Henry J. Kaiser Family Foundation

Medicaid Programs to Assist Low-Income Medicare Beneficiaries:  Working Paper on Medicare Savings Programs in Arizona

Medicaid Programs to Assist Low-Income Medicare Beneficiaries: Working Paper on Medicare Savings Programs in ArizonaThis report is a case study of Arizona's efforts to increase enrollment in their Medicare Savings Programs under Medicaid for low-income Medicare beneficiaries.Background Paper

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