Health Affairs October 25, 2023
Ryan Stringer, Michaella Morzuch

The high rates of health care needs among individuals who qualify both for Medicare and Medicaid, known as dually eligible individuals, concern many states and the Centers for Medicare and Medicaid Services (CMS). For example, 70 percent of dually eligible individuals have been diagnosed with three or more chronic conditions, 41 percent have a behavioral health disorder, and more than 40 percent use long-term services and supports (LTSS). These needs contribute to higher state and federal spending, in which dually eligible individuals account for a disproportionate share of Medicare and Medicaid spending.

Dually eligible individuals are increasingly enrolled in managed care plans for both Medicare and Medicaid benefits. The share of dually eligible individuals enrolled in Medicare Advantage plans grew...

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Topics: CMS, Govt Agencies, Insurance, Medicaid, Medicare, Patient / Consumer, Payment Models, Provider, States, Value Based
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