Briefing Detail Page
Integrating Care for Dual Eligibles: What Do Consumers Want?
Monday, December 12, 2011
The 9 million beneficiaries dually eligible for Medicare and Medicaid are generally poorer and sicker than other Medicare beneficiaries, tend to use more health care services, and thus account for a disproportionate share of spending in both programs. Many deficit reduction plans under recent discussion have recognized the need to improve care for this population and provide care in a more cost-effective way.
Dual eligibles present a special challenge for those seeking a more efficient and coordinated care delivery system. As integrated care models expand, consumer protections may be needed to assure choice and access to current providers and culturally appropriate services.
How do Medicaid and Medicare coordinate payment and care for people covered by both programs? Are HHS initiatives encouraging innovations to integrate care for dual eligible beneficiaries? What kinds of programs are currently available? What do consumers think about fee-for-service plans, special needs plans or other programs in which they are currently enrolled? What lessons for program design can policy makers learn from the attitudes of consumers?
To answer these and related questions, the Alliance for Health Reform and the AARP Public Policy Institute sponsored a December 12 briefing. Panelists were: Lindsay Barnette, Medicare-Medicaid Coordination Office at CMS; Lynda Flowers, AARP Public Policy Institute; Suzanne Gore, Center for Health Care Strategies; and Corrinne Altman Moore, Office of Medicaid, Massachusetts Executive Office of Health and Human Services. Susan Reinhard of AARP and Ed Howard of the Alliance co-moderated.
This briefing presented the results of two recent focus group studies that shed light on the experience of dual eligibles, which programs they prefer and how they and other stakeholders might be engaged in the program design process.
Susan Reinhard, AARP Public Policy Institute, Moderator
Lindsay Barnette, Centers for Medicare & Medicaid Services, Speaker
Lynda Flowers, AARP Public Policy Institute, Speaker
Corrinne Altman Moore, Office of Medicaid, Massachusetts Executive Office of Health and Human Services, Speaker
Suzanne Gore, Center for Health Care Strategies, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)
|Transcript, Event Summary and/or Webcast and Podcast|
Transcript: Transcript (Adobe Acrobat PDF), 12/12/2011
Event Summary: Event Summary (Adobe Acrobat PDF), 12/12/2011
Full Webcast/Podcast: Integrating Care for Dual Eligibles: What Do Consumers Want?
|The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.
Barnette Presentation (PowerPoint), 12/12/2011
Flowers Presentation (PowerPoint), 12/12/2011
Altman Moore Presentation (PowerPoint), 12/12/2011
Gore Presentation (PowerPoint), 12/12/2011
(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)
Agenda (Adobe Acrobat PDF), Alliance for Health Reform, 12/12/2011
Speaker Bios (Adobe Acrobat PDF), Alliance for Health Reform, 12/12/2011
Materials List (Adobe Acrobat PDF), Alliance for Health Reform, 12/12/2011
Source List (Adobe Acrobat PDF), Alliance for Health Reform, 12/12/2011
Event Summary (Adobe Acrobat PDF), , 12/12/2011
|Offsite Materials (briefing documents saved on other websites)|
Affordable Care Act Provisions Relating to the Care of Dually Eligible Medicare and Medicaid Beneficiaries, Kaiser Family Foundation, 5/1/2011
Improving the Qualified Medicare Benefit Program for Dual Eligibles (Adobe Acrobat PDF),National Senior Citizens Law Center, 11/1/2011
- Burke, Georgia, and Kevin Prindiville
Medicare and Medicaid Alignment: Challenges and Opportunities for Serving Dual Eligibles (Adobe Acrobat PDF),National Senior Citizens Law Center, 8/1/2011
- Burke, Georgia, and Kevin Prindiville
Care Management Practices in Integrated Care Models for Dual Eligibles (Adobe Acrobat PDF),AARP Public Policy Institute, 10/1/2010
- Burwell, Brian, et al
DataBrief: Dual Eligibles Across the States (Adobe Acrobat PDF),The SCAN Foundation, 2/1/2011
DataBrief: Dual Eligibles, Chronic Conditions, and Functional Impairment (Adobe Acrobat PDF),The SCAN Foundation, 10/1/2011
DataBrief: Dual Eligibles – Health Services Utilization (Adobe Acrobat PDF),The SCAN Foundation, 2/1/2011
DataBrief: Eligibility Pathways for Dual Eligibles (Adobe Acrobat PDF),The SCAN Foundation, 2/1/2011
Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries (Adobe Acrobat PDF),Kaiser Commission on Medicaid and the Uninsured, 5/1/2011
Integrating Medicare and Medicaid: State Experience with Dual Eligible Medicare Advantage Special Needs Plans (Adobe Acrobat PDF),AARP Public Policy Institute, 9/1/2009
- Edwards, Barbara Coulter, et al.
Refocusing Responsibility For Dual Eligibles: Why Medicare Should Take The Lead, Urban Institute, 10/1/2011
- Feder, Judy, Lisa Clemans-Cope, Teresa Coughlin, John Holahan, Timothy Waidmann
Experienced Voices: What Do Dual Eligible Want From Their Care?, AARP Public Policy Institute, 12/1/2011
- Flowers, Lynda et al.
The Role of Medicare for the People Dually Eligible for Medicare and Medicaid (Adobe Acrobat PDF),Kaiser Family Foundation, 1/1/2011
- Jacobson, Gretchen, Tricia Neuman, Anthony Damico, and Barbara Lyons
From the Beneficiary Perspective: Core Elements to Guide Integrated Care for Dual Eligibles, Center for Health Care Strategies, Inc., 12/1/2010
- Lind, Alice and Suzanne Gore
Engaging Consumer Stakeholders to Improve Systems of Care for Dual Eligibles (Adobe Acrobat PDF),Center for Health Care Strategies, Inc., 12/1/2010
- Lind, Alice and Suzanne Gore
Communicating the Value of Integrated Care to Stakeholders, Center for Health Care Strategies Inc., 11/1/2011
- Lind, Alice
For Patients in Both Medicare and Medicaid, Care Is Inefficient and Costly, The Heritage Foundation, 7/7/2011
- Nix, Kathryn
Ensuring Consumer Protection for Dual Eligibles in Integrated Models (Adobe Acrobat PDF),National Senior Citizens Law Center, 7/1/2011
- Prindiville, Kevin and Georgia Burke
Statement of Melanie Bella on Dually-Eligible Beneficiaries: Improving Care While Lowering Costs Before the U.S. Senate Committee on Finance (Adobe Acrobat PDF),U.S. Department of Health and Human Services, 9/21/2011
Texas to reduce Medicaid support for Medicare enrollees, American Medical News, 12/2/2011
- Trapp, Doug
Managing the Care of Dual Eligible Beneficiaries: A Review of Selected State Programs and Special Needs Plans (Adobe Acrobat PDF),Mathematica Policy Research, Inc., 6/1/2011
- Verdier, James, Melanie Au, and Jessica Gillooly
MassHealth’s Initiative to Create an Integrated Health Care Model for Dually Eligible Members: Member Focus Group Discussion (Word Document),University of Massachusetts Medical School, 7/21/2011
- Gettens, Jack, Monika Mitra, Linda Long-Bellil, and Alexis Henry
KanCare: Reinventing Medicaid for Kansas – Executive Summary, State of Kansas Office of the Governor, 11/1/2011
California’s 2010 Medicaid Waiver Stakeholder Process: Impact and Lessons Learned, California HealthCare Foundation, 11/1/2011
- Masters, Barbara, et al.
Proposal in Response to the Center for Medicare and Medicaid Innovation: State Demonstrations to Integrate Care for Dual Eligible Individuals (Adobe Acrobat PDF),Massachusetts Executive Office of Health and Human Services, 1/28/2011
Strategic Approach to Performance Measurement for Dual Eligible Beneficiaries, National Quality Forum, 11/1/2011
Susan Reinhard, director of the AARP Public Policy Institute, set the stage for a discussion of how best to care for individuals eligible for both Medicare and Medicaid at a Dec. 12 briefing on this topic, cosponsored by the institute. (4 min.)
Lindsay Barnette of the Centers for Medicare and Medicaid Services presented the results of focus groups with Medicare/Medicaid dual eligibles at the Dec. 12 briefing cosponsored by the AARP Public Policy Institute. (12 min.)
Lynda Flowers of the AARP Public Policy Institute discussed what Medicare/Medicaid dual eligibles think of five different models of care, at the Dec. 12 briefing cosponsored by the institute. (11 min.)
Corrinne Altman Moore of MassHealth described how Massachusetts is working to integrate care for Medicare/Medicaid dual eligibles, at the Dec. 12 briefing cosponsored by the AARP Public Policy Institute. Susan Reinhard, director of the Public Policy Institute, listens. (13 min.)
Suzanne Gore of the Center for Health Care Strategies discussed the importance of stakeholder engagement and good communications with Medicare/Medicaid dual eligibles, at the Dec. 12 briefing cosponsored by the AARP Public Policy Institute. (10 min.)
Alliance Search for New CEO
WASHINGTON, DC (Aug. 3) – Edward F. Howard, founding executive vice president and CEO of the Alliance for Health Reform in Washington, DC, will retire in March 2016. A nationwide search is underway for his successor.
Over the years, the Alliance has presented hundreds of seminars on Capitol Hill and elsewhere, has organized briefings for reporters around the country and has prepared dozens of issue briefs and “toolkits,” as well as a series of highly-regarded sourcebooks for reporters on health policy topics.
Dr. Robert Graham, Chairman of the Board, noted that the search for a new CEO is being coordinated by Association Strategies of Alexandria, Va. Those interested in learning more about this opportunity should email email@example.com or call 703/ 683-0580. You can also view the position profile on their website. The deadline for applications is Monday, October 12.
Toolkit on Biosimilars
The Alliance for Health Reform has released a new toolkit, “Biosimilars: Unpacking Complex Issues.”
The Affordable Care Act created an expedited licensure pathway for biosimilars, and, in March 2015, the U.S. approved the first biosimilar, leaving policy makers, regulators, providers and stakeholders to grapple with regulatory and financial questions.
Biosimilars are similar – but not identical – to biologic drugs, and cost less. Unlike traditional pharmaceuticals, biologic drugs are derived from living organisms and tissues, making them more complex and expensive to produce.