Group advocates for single, coordinated program for dual eligibles

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A leading Medicaid trade group told members of the so-called debt-reduction “super-committee” that shifting dual eligibles — individuals who are eligible for both Medicare and Medicaid benefits — into a single, coordinated program could save $148 billion in federal expenditures over 10 years.

Under a plan promoted by the group, states could either directly administer the program or contract with CMS for the program to be operated under Medicare. In both cases, states, the federal government and health plans could enter into three-way capitation contracts, according to a letter to members of the Joint Select Committee on Deficit Reduction from Thomas L. Johnson, president and CEO of Medicaid Health Plans of America. He noted that dual eligibles comprise 15% of Medicaid enrollees but more than 39% of Medicaid spending.

“Either way, combined payments would reflect anticipated savings achieved through a fully integrated program and states would be allowed to retain a portion of any realized savings to encourage their participation,” the letter states.

To read more about the plan, click here.