Improving Care for Dual Eligibles through Innovations in Financing

Health Policy Center, the Urban Institute, Washington, DC, USA.
New England Journal of Medicine (Impact Factor: 54.42). 08/2011; 365(11):e21. DOI: 10.1056/NEJMp1108571
Source: PubMed

ABSTRACT Elderly people and younger people with disabilities who are eligible for health coverage through both Medicare and Medicaid ("dual eligibles") are among the sickest and poorest people in the United States. Dual eligibles' extensive needs for medical and long-term care are often complicated by a perplexing and inefficient system of overlapping benefits, skewed incentives for health care providers, and financing fragmented between the federal and state governments. Medicare is the primary payer for dual eligibles and covers services including hospitals, physicians, and prescription drugs; Medicaid covers long-term care and is a secondary payer for Medicare-covered services. About 9.2 million Americans . . .

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