Yesterday the U.S. Senate Special Committee on Aging held a hearing examining the quality of care and the costs associated with providing for seniors who rely on both Medicare and Medicaid, known as dual eligibles.
Dual eligibles are often the most chronically ill and highest cost enrollees within the Medicaid and Medicare programs. “In our health care system today, dual eligibles are the most vulnerable of the vulnerable,” said Senator Herb Kohl (D-WI), Chairman of the committee. “The challenge for all of us is to figure out how to deliver care to them in a way that meets their needs but does not cost our health care system a fortune.”
The hearing focused on state specific programs as well as the Center for Medicare and Medicaid Services’ (CMS) newly launched care integration projects. Providing funding to state projects that better integrate care for dual eligibles, CMS’ Medicare-Medicaid Coordination Office is partnering with states to test new models. The program has already received applications from 26 states hoping to participate, so many states will likely be implementing new ways of providing care to dual eligibles.
Panelists largely emphasized the need for better care coordination when providing for those eligible for both Medicare and Medicaid. Progressing to a model that encourages home and community based services was also a highly cited priority. Tom Betlach, Director of the Arizona Health Care Cost Containment System, touted the progress Arizona’s program has made. “Over the past decade, the AHCCCS (Arizona Health Care Cost Containment System) program has progressed from 40 percent of its elderly and physically disabled members in the home or community to 72 percent, allowing Arizona to save $300 million this past year,” said Mr. Betlach. The benefits of home and community based care options was also highlighted in ALFA’s written testimony, which can be found on ALFA’s hearing page.
Each state provides for dual eligibles differently. ALFA encourages providers to work with their state officials to educate them on assisted living as a home and community based option and the benefits senior living communities can provide through cost savings and better coordinated care.
To read the panelists’ testimony or watch the hearing in its entirety, visit the U.S. Senate Special Committee on Aging’s website.
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