Mathematica Policy Research, Inc. has released a brief on dual eligibles' long-term care, and current opportunities and challenges for managed care to serve dual eligibles' long-term care needs.  The brief offers background on dual eligibles' care and outlines previous state efforts to coordinate their care.  The authors note that the current state of dual eligibles' long-term care poses both challenges and opportunities for managing their care, suggesting strategies to improve care provision while limiting costs.

 

From the report:

 

Incentives and resources for coordinated and cost-effective LTC for duals are not well aligned.  Costs of avoidable hospitalizations for dual eligibles fall on Medicare, so Medicaid has few incentives to invest in programs to reduce hospitalizations.

• Nursing facilities benefit financially if dual eligible Medicaid residents are hospitalized and return after three days at higher Medicare SNFrate
• Medicaid has lost access to Rx drug information needed to manage and coordinate care, and is generally not informed about hospitalizations

Full report: Long-Term Care and Dual Eligibles: Overview and Managed Care Opportunities (PDF | 153.60 KB)

 

Mathematica Policy Research, Inc.  (2011).  Long-term care and dual eligibles: overview and managed care opportunities.  Verdier, J.