There are multiple pathways to becoming dually eligible for Medicare and Medicaid. The purpose of this study is to identify the frequency with which these pathways are followed and the beneficiary characteristics and patterns of service use by pathway.
Medicare-Medicaid Dual-Eligible
Reports
Displaying 21 - 30 of 35. 10 per page. Page 3.
Advanced SearchLoss of Medicare-Medicaid Dual Eligible Status: Frequency, Contributing Factors and Implications
This paper seeks to document the frequency of Medicaid coverage loss among full-benefit dual eligible beneficiaries and identify potential causes for coverage loss. For dual eligible beneficiaries, the loss of full-benefit Medicaid coverage is of concern because most of them do not have an alternative source of health insurance for the services covered by full-benefit Medicaid.
Integrating Care through Dual Eligible Special Needs Plans (D-SNPs): Opportunities and Challenges
The 11 million individuals dually-eligible for Medicare and Medicaid are among the highest need populations in either program. However, a lack of coordination between the Medicare and Medicaid programs makes it difficult for individuals enrolled in both to navigate these fragmented systems of care and adds to the cost of both programs.
Environmental Scan
Types and Costs of Services for Dual Beneficiaries by Medicare Advantage Health Plans: An Environmental Scan
The Centers for Medicare and Medicaid Services (CMS) uses the Star Rating program to measure the quality of Medicare Advantage (MA) plans, publicly report plan performance, and determine quality bonus payments and rebates for MA plans.
Addressing Social Determinants of Health Needs of Dually Enrolled Beneficiaries in Medicare Advantage Plans: Findings from Interviews and Case Studies
Medicare Advantage (MA) plans that serve relatively higher proportions of dually enrolled beneficiaries have lower ratings in the MA Star Rating program than plans that serve fewer dually enrolled beneficiaries. However, some MA plans that serve a high proportion of dually enrolled beneficiaries are high performers.
Transitions from Medicare-Only to Medicare-Medicaid Enrollment
This study focuses on understanding the rates and patterns of enrollment in Medicaid among individuals already enrolled in Medicare, the factors that predict this transition to dual coverage, and those that predict nursing home entry. This volume of this report is a descriptive examination of the
Effectiveness of Alternative Ways of Implementing Care Management Components in Medicare DSNPs:The Care Wisconsin and Gateway Study
Little information exists on how to design various components of care coordination interventions for complex patients to reduce patients’ needs for hospitalizations or emergency room use. Efficient orthogonal design--a methodology widely used in manufacturing and marketing, but rarely used in
Effectiveness of Alternative Ways of Implementing Care Management Components in Medicare D-SNPs: The Brand New Day Study - Executive Summary
Jelena Zurovac, Randy Brown, Bob Schmitz and Richard Chapman Mathematica Policy Research January 2014