dual eligibles

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For The Most Expensive Patients: Better Care, More Savings (Hopefully)

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WBUR’s Martha Bebinger reports:

Massachusetts is rolling out a pilot project that aims to provide better care and save money for some of the state’s most expensive patients.

About 111,000 young and middle aged adults with serious medical problems are on both Medicare and Medicaid. Figuring out which services the different programs cover can be a nightmare. There are a few programs that pool Medicare and Medicaid money for older Americans (65 and up). Now, for the first time, Massachusetts will merge Medicare and Medicaid resources for younger adults so that they have one package of coordinated medical and support services.

“This is an approach that will not only simplify the member experience,” says Medicaid director, Dr. Julian Harris, “but will also improve their care experience by ensuring that providers are working together as a team to make sure their care needs are met.”

Providers have until the end of July to submit a proposal for covering so-called dual eligibles through this demonstration project. Harris expects to begin enrolling patients early next year.

The Patrick administration says this change could save 2% of Medicaid and Medicare spending over the three year term of the demonstration.