Report: New CMS office could better serve dual eligibles

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The Centers for Medicare & Medicaid Services should create an office for dual eligibles, those seniors  dually eligible for Medicare and Medicaid, a new report suggests. It would reduce the "silo effect" and lead to better, more cost-effective treatment for this population.

Although they comprise only 18% of overall Medicaid enrollment, dual eligibles consume 46% of the program's resources, according to the report, "Supporting Integrated Care for Dual-Eligibles," from the Center for Health Care Strategies Inc., a nonprofit health policy center. Up to 80% of dual-eligibles remain in fee-for-service type plans, despite the increased availability of integrated care plans through Medicare Advantage and other special needs plans (SNPs), report authors say. One way to coordinate care and reconcile differences in Medicare and Medicaid policy concerning dual eligibles would be to create an office within CMS that "establishes one place to go for policies, procedures, and tools to support integration," according to the report.

Congress should also consider expanding states' options for integrating care, authors suggest. Increasing authority for states to conduct new demonstration or pilot programs, and investigate "alternative options" for integrating care could help improve quality and decrease cost, the report says. To view the full report, which was released July 30, visit http://www.chcs.org/usr_doc/Integrated_Care_Policy_Brief.pdf.

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