Forum Session

Providing appropriate and efficient care for the 9 million people enrolled in both Medicare and Medicaid—the "dual eligibles"—is a major policy challenge. Dual eligibles represent a small proportion of each program’s enrollees but account for a disproportionate share of health care costs. Often overlooked, however, is the heterogeneity of health care needs and spending of the dual eligible population and the potentially different approaches to addressing care delivery and costs for specific subgroups. Some dual eligibles are in relatively good health and do not account for significant spending. Others, however, account for significant Medicare spending for acute and chronic medical care costs. Many of these dual eligibles have significant disabilities and incur high Medicaid spending for long-term services and supports (LTSS), primarily in the form of institutional care. This Forum session explored the diverse group of individuals who are eligible for both Medicare and Medicaid. Speakers discussed initiatives by the Centers for Medicare & and Medicaid Services (CMS) to integrate financing streams, improve service delivery, and reduce overall health care costs for this population; examined some of the challenges in serving diverse high cost patient groups; and considered consumer protections that should be in place for those who participate in integrated care models.

• Sally Coberly, PhD
  Deputy Director
  National Health Policy Forum
  Slides


• Paul F. Soczynski, MBA
  Director, Government Services
  Accuity, Inc.
  Skokie, Illinois
  Slides


• Melanie Bella, MBA
  Director
  Federal Coordinated Health Care Office
  Centers for Medicare & Medicaid Services
  Slides


• Kevin Prindiville, JD 
  Deputy Director
  National Senior Citizens Law Center
  Oakland, California
  Slides