States Push Feds To Include 3 Million 'Dual Eligibles' In Pilot Program

Though only designed for 2 million beneficiaries, states want the federal government to open a pilot program on dual eligibles -- those who qualify for both Medicare and Medicaid -- to 3 million. In the meantime, California is shifting its dual eligibles to managed care.

Modern Healthcare: Dual-Eligibles Pilot Program Faces Rush From States
States want to include more than 3 million dual-eligible beneficiaries in a CMS pilot program to overhaul their care and payments.  The number is 1 million more than the program was designed for and represents about a third of all that category's beneficiaries, whose care is one of the biggest drivers of the growth in Medicaid costs (Daly, 5/7).

California Healthline: Risks, Rewards Higher for Managing Dual Eligibles 
The state is working to shift older, low-income Californians eligible to receive Medi-Cal and Medicare -- known as dual eligibles -- into managed care plans, hoping to coordinate and improve care, as well as save money. The state also is shifting Medi-Cal beneficiaries participating in the Multi-Purpose Senior Services Program into managed care. ... About 60 percent of the 7.6 million people covered by Medi-Cal are in managed care plans. ... The most-expensive Medi-Cal beneficiaries, many of them older with multiple chronic conditions, are still in fee-for-service plans (Lauer, 5/7).

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