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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

Current and Emerging Issues in Medicaid Risk-Based Managed Care: Insights from an Expert Roundtable

Half of all Medicaid enrollees receive care through comprehensive risk-based managed care organizations (MCOs). Most Medicaid MCO enrollees today are low-income children and parents, but states are increasingly moving beneficiaries with more complex needs into MCOs. Managed care enrollment may grow more rapidly as states work with the Centers for…

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The Henry J. Kaiser Family Foundation

Best Bets for Reducing Medicare Costs for Dual Eligible Beneficiaries: Assessing the Evidence

With pressure mounting to slow the growth in federal health care spending, policymakers are exploring ways to reform the way care is delivered to the 9 million low-income Medicare beneficiaries who also receive Medicaid – a group that on average is sicker and frailer than other Medicare beneficiaries, and therefore…

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The Henry J. Kaiser Family Foundation

Medicare/Medicaid Dual Eligibles: Fiscal and Social Responsibilities for Vulnerable Populations

Report: Medicare/Medicaid Dual Eligibles: Fiscal And Social Responsibility For Vulnerable Populations

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The Henry J. Kaiser Family Foundation

Out-of-Pocket Cost-Sharing Obligations for Low-Income Medicare Beneficiaries Under the House and Senate Prescription Drug Bills

This issue paper provides information on the out-of-pocket expenses for prescription drugs that low-income individuals would face under the Senate versus the House Medicare prescription drug benefit legislation. Issue Paper (.pdf)

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The Henry J. Kaiser Family Foundation

Prescription Drug Coverage for Medicare Beneficiaries: A Summary of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

This document, prepared by Health Policy Alternatives, Inc., provides a detailed summary of the prescription drug provisions of the Medicare legislation (P.L. 108-173) signed by the President on December 8, 2003.Report (.pdf)

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The Henry J. Kaiser Family Foundation

The New Medicare Drug Benefit:  Potential Effects of Pharmacy Management Tools on Access to Medications

The New Medicare Drug Benefit: Potential Effects of Pharmacy Management Tools on Access to MedicationsThis report describes the pharmacy benefit management tools that will be available to private plans administering the new Medicare drug benefit, including formularies, the definition of categories and classes, and cost sharing requirements. The authors conclude…

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The Henry J. Kaiser Family Foundation

Grievance and Appeals Procedures: An Analysis of the MMA and Proposed Regulations

This paper, by Sara Rosenbaum, J.D., Director of the Center for Health Services Research and Policy at George Washington University, examines the procedures for resolving beneficiaries' grievances and appeals under the new Medicare drug benefit. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues…

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The Henry J. Kaiser Family Foundation

Marketing and Privacy Issues: An Analysis of the MMA and Proposed Regulations

This paper, by Joy Pritts of the Health Policy Institute at Georgetown University, looks at issues related to drug plan marketing activities and privacy under the MMA.Issue Brief (.pdf)

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The Henry J. Kaiser Family Foundation

Navigating Medicare and Medicaid: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

Navigating Medicare and Medicaid: Resource Guides for People with Disabilities, Their Families, and Their AdvocatesThese guides explain the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities – and give people with disabilities new…

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The Henry J. Kaiser Family Foundation

Summary of Final Regulations Implementing the New Medicare Prescription Drug Benefit

This document summarizes the final regulations to implement the new Medicare prescription drug benefit. The regulations were published by the Centers for Medicare and Medicaid Services (CMS) as a final rule in the Jan. 28 Federal Register. It provides an overview that allows interested parties to obtain information about specific…

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