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Policy Support

Medicare and Medicaid Integration 

Background

Approximately 9.2 million Americans are covered simulataneously by both Medicare and Medicaid, a population commonly known as “dual eligibles.” Integration and coordination of care is crucial for keeping down costs while providing quality care to this vulnerable population. Accomplishing this task will require new and innovative payment and delivery system, as well as partnerships between the federal and state goverments, community health plans and provders. Large-scale savings can be achieved in transitioning the dual eligible population into a fully integrated, capitated setting like a managed care organization (MCO). In addition, MCOs have been shown to provide greater outreach, case management and other non-financial benefits.

ACAP Position and Legislative Action

After years of little coordination, the Patient Protection and Affordable Care Act established an office in the Department of Health and Human Services focused on intergrating its policy treatment of dual eligibles.

ACAP urges all parties to work toward increasing Medicare and Medicaid integration in order to provide high quality and coordinated care to dual eligibiles.

 

 

Medicare and Medicaid Integration 

Background

Approximately 9.2 million Americans are covered simulataneously by both Medicare and Medicaid, a population commonly known as “dual eligibles.” Integration and coordination of care is crucial for keeping down costs while providing quality care to this vulnerable population. Accomplishing this task will require new and innovative payment and delivery system, as well as partnerships between the federal and state goverments, community health plans and provders. Large-scale savings can be achieved in transitioning the dual eligible population into a fully integrated, capitated setting like a managed care organization (MCO). In addition, MCOs have been shown to provide greater outreach, case management and other non-financial benefits.

ACAP Position and Legislative Action

After years of little coordination, the Patient Protection and Affordable Care Act established an office in the Department of Health and Human Services focused on intergrating its policy treatment of dual eligibles.

ACAP urges all parties to work toward increasing Medicare and Medicaid integration in order to provide high quality and coordinated care to dual eligibiles.

 

 

 Description 
MedPAC. "Coordinating the care of dual-eligible beneficiaries." June 2010.Download
Center for Health Care Strategies, Melanie Bella and Lindsay Palmer-Barnette. "Options for Integrating Care for Duals." March 2010.Download
CMS and Booz Allen Hamilton. "State Options for Designing Dual SNP Contracts with Medicare Advantage Organizations that Adhere to MIPPA Requirements." December 2009.Download
Center for Health Care Strategies. "Supporting Alternative Integrated Models for Dual Eligibles: A Legal Analysis of Current and Future Options." November 2009.Download
AARP. "Integrating Medicare and Medicaid: State Experience with Dual Eligible Medicare Advantage Special Needs Plans." September 2009.Download
ACAP Response to 2009 SNP Structure and Process MeasuresDownload
Lewin Group with ACAP and MHPA. "Increasing Use of the Capitated Model for Dual Eligibles: Cost Savings Estimates and Public Policy Opportunities." November 2008.Download
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News

ACAP Celebrating Its 10th Anniversary!

ACAP is celebrating its 10th anniversary this year! The association was originally formed by health plans affiliated with community health centers, but it soon expanded to represent other community-based, nonprofit health plans.  Today, ACAP plans are the backbone of the Medicaid managed care program, which since 2000 has grown from serving 12 million to nearly 22 million low-income Americans.  Several ACAP members also operate Medicare Special Needs Plans (SNPs), managed long-term care plans, and state and local initiatives for the uninsured.

Press Release: "ACAP Celebrates Its 10th Anniversary"
Brochure: "About ACAP 2000-2010"

ACAP Celebrating Its 10th Anniversary!

ACAP is celebrating its 10th anniversary this year! The association was originally formed by health plans affiliated with community health centers, but it soon expanded to represent other community-based, nonprofit health plans.  Today, ACAP plans are the backbone of the Medicaid managed care program, which since 2000 has grown from serving 12 million to nearly 22 million low-income Americans.  Several ACAP members also operate Medicare Special Needs Plans (SNPs), managed long-term care plans, and state and local initiatives for the uninsured.

Press Release: "ACAP Celebrates Its 10th Anniversary"
Brochure: "About ACAP 2000-2010"