HHS announces new Medicare-Medicaid cost control initiatives

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Don Berwick
Don Berwick
A new program from the Department of Health and Human Services will seek to improve care of dual-eligibles, the agency said Wednesday.

The Alignment Initiative is an effort to integrate benefits for those eligible for both Medicare and Medicaid, a huge number of whom reside in long-term care facilities. It will be led by the Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office), which was created under the Affordable Care Act.

The 9 million dual eligibles in the U.S. are among the poorest and sickest, and they must currently navigate both Medicare and Medicaid programs. While Medicare provides coverage of basic acute health care services and drugs, Medicaid offers long-term care supports and services, such as skilled nursing care. Resolving discrepancies between both programs can be time consuming and expensive: Medicare and Medicaid spend $300 billion each year to care for these individuals, said Centers for Medicare & Medicaid Services Administrator Donald M. Berwick, M.D.

“Medicaid costs are largely driven by the complex medical needs of low-income seniors and people with disabilities who are eligible for both Medicare and Medicaid. We know that by working together, we can provide better, more coordinated care while lowering health care costs and saving money for states,” Berwick said. HHS also said it will share Medicare data related to areas such as prescription drug use and hospital visits in order for states to contain costs.

Comments on the program are being accepted until July 11, 2011.