The Cost-Containment Problem With Dual-Eligibles

NCHC Writers
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News Article


Overlapping Health Plans Are Double Trouble for Taxpayers

July 1, 2011

Issue Areas: 

CostVulnerable Populations

As the United States struggles with containing health cost, one specific group of patients stands out as expensive and difficult to manage: those eligible for both Medicare and Medicaid. Currently there are approximately 9.7 million dual-eligibles. They account for 27% of Medicare spending and 39% of Medicaid spending.  Most of the increased cost comes from the use of nursing homes as well as chronic diseases.  However, a major problem is how the medical bills are divided between the payers: federal government for Medicare and state governments for Medicaid. Because of the poor coordination between the two programs and the conflicting incentives, dual-eligible patients are receiving sub-par care and government health care costs are rapidly increasing.

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