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Apr 19, 2019

Today, over 12 million individuals are enrolled in both Medicaid and Medicare. These “dual eligible” individuals typically have high rates of chronic illness, many with multiple chronic conditions and/or social risk factors.

In a recent letter to state Medicaid directors, the Centers for Medicare and Medicaid services (CMS) outlined ten opportunities to better serve dual eligible populations. These opportunities are the result of new developments in managed care, Medicare data sharing, and reducing administrative burden for dual-eligibles and their providers.

CMS is encouraging states to take advantage of these opportunities to create more seamless experiences for dual-eligibles and to improve how both the Medicare and Medicaid programs work together.

In this edition of Episode Intelligence, Vicki Jessup, director of government relations for Change Healthcare, shares insights into what the opportunities outlined by CMS mean to states, health plans, and their members with Keslie Crichton, VP of sales for Change Healthcare’s member engagement and dual eligible solutions.

In today's show they discuss:

  • How the opportunities outlined by CMS impact Medicare Advantage plans and members (02:10)
  • How more frequent data exchange improves coverage and payment accuracy (04:37)
  • The meaning of and opportunities surrounding Medicare Part A buy-in enrollment (08:33)
  • How some states are simplifying eligibility and enrollment for Medicare savings programs (12:11)

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  6. Blending AI and Behavioral Science to Improve Dual Eligibility Advocacy
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