Improved coordination of dual eligibles could save the federal government $125 billion over 10 years, report says

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Requiring dual eligibles — individuals receiving both Medicare and Medicaid benefits — to enroll in team-based coordination of care programs could save the federal government $125 billion over 10 years, a new report finds.

Dual eligibles, who are often elderly, disabled or have chronic health conditions, are among the most costly Americans to cover. More than nine million people were considered dual eligibles in 2010, but fewer than 2% are enrolled in coordinated care programs, according to the report, written by Kenneth Thorpe, Ph.D., professor of health and policy management at Emory University. Dual eligibles account for 16% of Medicare enrollees but 27% of the program's spending, The Hill reported.

Underscoring the need for improved coordination of care for dual eligibles, members of Senate Finance Committee grilled an official from the Medicare-Medicaid Coordination Office about the speed with which the agency is working on the issue.

When asked by Sen. Max Baucus (D-MT) about goals and metrics the agency has thus far set to reduce costs, Melanie Bella, director of that office, said “Of the 9 million duals, we believe that about 100,000 are in a fully integrated system with an entity that is accountable clinically and financially for their care.”

She added that the office has a one-year goal of placing one million dual eligibles into coordinated care by the end of 2012, according to a transcript of the hearing.
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