Huge opportunity for dual eligible cost savings, report says

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Better coordination of care for individuals eligible for both Medicare and Medicaid could result in savings of nearly $190 billion by 2022, according to a recent UnitedHealth Center report.

Medicare and Medicaid spending on dual eligibles is estimated to reach $330 billion in 2013, according to the report. The long-term care sector will be significantly impacted by efforts to bring this number down in the future, as a majority of the $150 billion in Medicaid spent on dual eligibles is for long-term care services. 

The Centers for Medicare & Medicaid Services (CMS) is acting to address spending on dual eligibles through a Financial Alignment Demonstration model. In the most popular version of this model, a managed care plan or an organization such as an Accountable Care Organization receives blended payment streams of Medicare and Medicaid.

UCH estimates the current CMS model will cover roughly one-fifth of all dual eligible beneficiaries. The report proposes states can more aggressively institute managed care models to better manage Medicaid funds for dual eligibles.

The number of dual eligibles is certain to increase as implementation of the Affordable Care Act swells Medicaid rolls, PricewaterhouseCoopers stated Wednesday. The firm noted that 70% of state Medicaid spending on duals goes to long-term care services. 

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