Report: Dual eligibles challenge New York's healthcare reform plans

Share this article:
The dual-eligible population of New York--those elderly individuals enrolled in both Medicare and Medicaid--pose a significant cost burden on the healthcare system, and hinder reform efforts, according to a report released last week by the United Hospital Fund.

Dual eligibles, many of whom reside in long-term care facilities, are the single highest cost group in the state Medicaid program. One statistic shows that 20% of dual eligibles-52,000-live in New York City alone. This group accounts for $3.5 billion in Medicaid spending. More than 40% of New York's healthcare expenditures are directed toward dual eligibles, according to the report.

Among the policy challenges caused by dual eligibles: Because they rely on long-term care for help with activities of daily living, managing their care means maintaining their health status more than preventing conditions. Also, state regulations prevent Medicaid from dictating terms of treatment unless there are new policy provisions. Assessing the effectiveness of service delivery and the level of spending relative to health outcomes will be key to finding solutions, according to the report's author.
Share this article:
close

Next Article in News

More in News

Medicare rates could be adjusted for start and end of hospice care ...

Medicare payments could be adjusted to reflect how hospice services tend to be more intensive at the beginning and end, according to findings recently published by the Centers for Medicare & Medicaid Services Office of Information Products & Data Analytics.

Nursing home resident dies after allegedly being smothered by son

A terminally ill nursing home resident died after his intoxicated son tries to suffocate him, local police say. Roy Curtis, 86, reportedly died hours after his son was arrested.

Medicare should pay for skilled nursing services without a qualifying hospital stay, experts tell Senators

Medicare should pay for skilled nursing services without ...

The time has come to eliminate hospital stay requirements for beneficiaries to qualify for Medicare coverage of skilled nursing services, experts told a Senate committee Wednesday.