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  • Displaced by Hurricane Katrina: Issues and Options for Medicare Beneficiaries

    Issue Brief

    An estimated 200,000 Medicare beneficiaries were displaced by Hurricane Katrina. Medicare played a key role in meeting the health care needs of the elderly and disabled beneficiaries who were displaced by the hurricane. Many of these beneficiaries face new challenges as a direct result of the hurricane. This issue brief identifies issues and challenges for individuals on Medicare affected by the hurricane and offers options for addressing these problems during the transition period. This issue…

  • The Stability of Medicaid Coverage for Low-Income Dually Eligible Medicare Beneficiaries

    Report

    This report examines the stability of dual eligibility for the seven million Americans who rely on Medicaid to fill the gaps in their Medicare coverage and its implications for Medicare's new prescription drug benefits. The analysis focuses on the duration of dual eligibility, the rates of gain and loss of Medicaid coverage and sources of Medicare supplementation preceding and following periods of Medicaid enrollment. The paper analyzes data from the Medicare Current Beneficiaries Surveys from…

  • Pulling it Together: Duals: The National Health Reform Experiment We Should Be talking More About

    From Drew Altman

    The Center for Medicare & Medicaid Services (CMS) and 26 states are moving to launch a large scale managed care demonstration project potentially involving millions of the poorest, sickest, most expensive Medicare and Medicaid beneficiaries, the so-called dual eligibles. The experiment is getting more and more attention from policy experts, but with controversial issues like the survival of the Affordable Care Act and converting Medicare to a premium support program grabbing the limelight, it has…

  • Reports Analyze Cost and Coverage of People Eligible for Both Medicaid and Medicare and Options for Reforming Financing of Their Care

    Issue Brief

    These issue briefs examine coverage of the nearly 9 million "dual eligibles," the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. The reports explore the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, and provide state-level Medicaid spending and enrollment data related to this population. The policy options studied could collectively provide tens of billions of dollars in annual…

  • The Role of National Firms in Medicare+Choice

    Report

    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 use when making decisions and the key factors they say most influence their decisions related to participation. Report

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

    Report

    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 these models. CMS is presently reviewing the states' proposals to determine which will be implemented. This background paper examines the contents of the 26 states'…

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

    Issue Brief

    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 and the structure of low-income subsidy programs. The way in which these issues are resolved will have major implications for Medicaid beneficiaries, other low-income individuals,…

  • Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    This updated fact sheet describes the nearly 8.9 million "dual eligibles," the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid, why this population needs Medicaid, what services they receive from Medicaid, and what the new health reform law may mean for them. Fact Sheet (.pdf)

  • Medicaid’s Long-Term Care Users: Spending Patterns Across Institutional and Community-based Settings

    Issue Brief

    The nation's primary payer for long-term services and supports, Medicaid finances 43 percent of all spending on long-term care services and covers a range of services and supports, including those needed by people to live independently in the community, as well as services provided in institutions. This report provides an overview of long-term care users and their acute and long-term care service spending. The report finds that although the individuals who rely on long-term care…