Dual Eligible Beneficiaries

Elevance Health’s $2.5B Acquisition of BCBSLA Paused a Second Time

February 16, 2024 - Blue Cross Blue Shield Louisiana (BCBSLA) announced that it will not move forward with plans to be acquired by Elevance Health. “We continue to hear from our stakeholders that they want Blue Cross and Blue Shield of Louisiana to remain their trusted partner in their healthcare journey, and we pursued this transaction to help us do exactly...

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Does Integrating Medicare and Medicaid Improve Care for Dual Eligibles?

by Victoria Bailey

Integrating Medicare and Medicaid coverage for dual eligible beneficiaries was associated with higher use of home- and community-based services (HCBS) but did not reduce hospitalization or improve care...

High Switching Rates from FFS to Medicare Advantage Drove MA Enrollment

by Victoria Bailey

Increased rates of switching from Medicare fee-for-service (FFS) to Medicare Advantage in recent years have contributed to Medicare Advantage enrollment growth, a study published in Health Affairs...

Medicare, Medicaid Spending Similar Among Dual Eligible Beneficiaries

by Victoria Bailey

Need-based subgroups of dual eligible beneficiaries utilized both Medicare- and Medicaid-funded services, identifying the need for an integration program that includes benefits from both payers, a...

How to Protect Integration Progress As Medicare-Medicaid Plans Sunset

by Kelsey Waddill

As CMS sunsets the Medicare-Medicaid plan model, Congress and the agency will need to take steps to expand the Medicare-Medicaid Coordination Office (MMCO) oversight capabilities and protect the...

States Use Managed Care, PACE, FAIs to Boost Dual Eligible Care Coordination

by Kelsey Waddill

Updated 5/2/2023: This article's title has been updated to say "States Use Managed Care, PACE, FAIs to Boost Dual Eligible Care Coordination." A previous version misspelled the acronym FAI as...

Traditional Medicare to Medicare Advantage Switching Rates Grew in 2020

by Victoria Bailey

The share of beneficiaries who switched from traditional Medicare to Medicare Advantage in 2020 exceeded the switching rate from Medicare Advantage to traditional Medicare, contributing to Medicare...

5 Considerations for Payers before Entering Dual Eligible Market

by Kelsey Waddill

The dual eligible market is changing, creating new challenges and opportunities that health plans should take into account when considering entering the market, experts from Manatt Health found in a...

Proposed Rule May Prevent Coverage Losses for Dual Eligible Beneficiaries

by Victoria Bailey

The CMS proposed rule to streamline the Medicaid eligibility process could potentially prevent coverage losses for around a third of dual eligible beneficiaries, according to data from the Kaiser...

SCAN Health Plan Expands Dual Eligible Special Needs Plan in CA

by Victoria Bailey

SCAN Health Plan is expanding its California Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) into San Diego County for 2023, increasing access to the state’s only FIDE-SNP. SCAN...

SDOH, Nonmedical Supplemental Benefits Lacking for MA Dual Eligibles

by Victoria Bailey

Medicare Advantage plans that exclusively serve dual eligible beneficiaries offered more social determinants of health (SDOH) and nonmedical supplemental benefits than general Medicare Advantage plans,...

Key Steps to Improve Coverage Integration for Dually Eligible Individuals

by Kelsey Waddill

In its June 2022 report to Congress, MACPAC laid out ways that states can improve the integration of Medicare and Medicaid coverage for dually eligible individuals. “Fully integrated models are...

CMS Introduces Health Equity Strategy for Public Payer Programs

by Kelsey Waddill

CMS has released its strategy for health equity, which is the first pillar in the agency’s strategic vision. “Advancing health equity is the core work of the Centers for Medicare &...

MACPAC Highlights Dual Eligible Challenges in CMS Proposed Rule

by Kelsey Waddill

Transitioning Medicare-Medicaid plans into dual eligible special needs plans may pose challenges that the proposed rule for 2023 Medicare Advantage and Medicare Part D policy and technical changes...

MACPAC Shares Spending Trends Among Dual Eligible Beneficiaries

by Kelsey Waddill

MACPAC has released data on utilization and healthcare spending trends among dual eligible beneficiaries in calendar year 2019. First, the report assessed dual eligible use of certain Medicare...

CMS Releases 2023 Medicare Advantage, Part D Proposed Rule

by Kelsey Waddill

CMS released the calendar year 2023 Medicare Advantage and Part D proposed rule which aims to improve network adequacy, elucidate medical loss ratio reporting, open the possibility of assigning star...

More Medicare Beneficiaries with COPD Enrolled in FFS Than MA

by Victoria Bailey

The majority of Medicare beneficiaries with chronic obstructive pulmonary disease (COPD) are enrolled in fee-for-service Medicare, but the share of beneficiaries in Medicare Advantage plans is...

Medicaid Asset Test Revisions May Increase Dual Eligibility for Seniors

by Victoria Bailey

Adjusting the Medicaid asset test to accurately reflect inflation levels could increase Medicaid eligibility for low-income, elderly, and disabled Medicare beneficiaries, according to a Health Affairs...

Dual Eligible Beneficiaries Prefer Medicare Advantage Over FFS

by Victoria Bailey

Dual eligible beneficiaries were more likely to choose a Medicare Advantage plan over a fee-for-service Medicare plan, a study commissioned by Better Medicare Alliance (BMA) found. To understand the...

Humana Expands Medicare Advantage Plans, Benefits in Tennessee

by Victoria Bailey

Humana has announced several Medicare Advantage expansions for Tennessee in 2022, including a Dual Eligible Special Needs Medicare Advantage (D-SNP) plan and COVID-19 testing, treatment, and...

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