Dual-eligible Dilemma

Policymakers are hoping moving Medicare- and Medicaid-eligible seniors and the disabled into managed-care plans will save taxpayers a lot of money through better coordination of care. But as a few state demonstration programs get off the ground, critics are beginning to question just how cost-effective the strategy will be.

“I think they will struggle in the beginning, (but) they will definitely save money, but not the giant projections” some are making, said Charlene Frizzera, a senior adviser with consultancy Leavitt Partners and a former acting administrator for the CMS.

The dual-eligibles, all of whom are poor and many of whom have multiple chronic conditions, are among the highest cost people in the healthcare system. To better manage their costs, five states have launched demonstration programs to register this population in managed-care plans.

Proponents say these programs are a win-win for enrollees and states. Seniors get better coordinated care and states can cut costs.

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Source: Modern Healthcare