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Dual eligibles, individuals enrolled in both Medicare and Medicaid, are among the highest-need, highest cost patients in the United States. Although it is difficult to determine the exact number of dual eligibles, a 2012 Kaiser Family Foundation report estimates that dual eligibles comprise 21 percent of the Medicare population and 15 percent of the Medicaid […]
Dual-eligible enrollees account for a disproportionately sizeable proportion of spending in both Medicare and Medicaid programs. However, until recently, these nearly 11.5 million[i] enrollees have not been in the spotlight in discussions regarding the move toward value-based payments.
Not Losing Sight of the Dual Eligible in the Move to Value Based Payments Value-based payments arrangements are increasing. While most of this movement is being driven through Medicare-based payment initiatives, CMS is now increasingly pushing value-based payments in Medicaid based on the success CMS has achieved in Medicare. The shift to value-based payments is […]
Leavitt Partners releases “The Rise and Future of Medicaid ACOs,” which contains a state-by-state landscape analysis Salt Lake City, September , 2015 — No two models nor markets are alike, and the pace and prevalence of Medicaid accountable care growth will largely depend on states’ ability to generate savings and successfully overcome common and unique […]
On Friday, the Centers for Medicare and Medicaid Services (CMS) announced their proposed Medicare rate adjustments. Estimates forecast a 3.5% increase for Medicare Advantage plans after adjusting for coding practices. CMS also intends to “improve payment precision and encourage quality” with the possibility of some changes to the star rating system. The proposed changes represent […]