Individuals who are eligible for both Medicare and Medicaid often have complex care needs that strain the health care delivery system. Approximately 9 million people make up the "dually eligible" population nationwide, which includes older adults and low-income individuals with disabilities.
To improve health care for dually eligible individuals, the ACA and other federal initiatives have created opportunities to reform and better integrate how care is provided and financed. Federal funding has been made available to support many of these activities through demonstration projects.
Our work ensures that dually eligible individuals receive comprehensive care and benefits. Our team can help states develop and implement demonstration projects that support this population — eliminating barriers to care while also containing costs.
Our work focuses on designing demonstration projects which ensure that Medicare covers all appropriate services, and that state Medicaid programs are the payers of last resort. Our model of support for ongoing stakeholder groups establishes collaboration methods needed to implement and improve these demonstration projects. We have developed proprietary data-matching techniques that can identify dually eligible individuals who are not always detected through existing matching procedures. This maximizes savings for states – while ensuring that dually eligible individuals get the integrated care and services to which they are entitled.