As Congress searches for health care savings, care coordination for dual eligibles may offer an opportunity

Sep 23 2011

Sen. Ron Wyden, D-Ore., said during a Wednesday Senate Finance Committee hearing that the current lack of coordination for people who are on both Medicare and Medicaid leads to massive amounts of waste and low-quality care, but an Obama administration official said more time was needed to address this issue. Also, a new report written by Emory University's Kenneth Thorpe and funded by America's Health Insurance Plans sets a high possible savings estimate if this coordination goal can be achieved.

The Hill: Wyden Urges Super Committee To Improve Care Coordination In Medicare and Medicaid
Oregon Sen. Ron Wyden's patience ran out during a hearing Wednesday on ways to improve care for the nine million people who make up a disproportionate chunk of government health care spending. The federal government has been struggling for decades to improve care for the so-called "dual eligibles" who are enrolled in both Medicare and Medicaid, most of whom are low-income seniors or people with disabilities. The lack of coordination between the two programs has led to massive amounts of waste and sub-par care, prompting the Democratic senator to demand that the deficit-cutting super committee take up the issue (Pecquet, 9/21).

Kaiser Health News: Capsules: Report: Savings Of $125B Possible For Coordinating Care Of Dual Eligibles
The federal government could save $125 billion over ten years by requiring all people who get both Medicare and Medicaid – dual eligibles – to enroll in team-based coordinated care programs, according to a report written by Emory University's Kenneth Thorpe and funded by America's Health Insurance Plans. States could save $34 billion, and the savings would be less at both the federal and state level if dual eligibles were allowed to opt out, Thorpe wrote. The report comes as the deficit reduction super committee contemplates how to save more than $1 trillion. Health care interests, fretting over the prospect of big cuts, are beginning to point members of the committee toward proposals that would save money by creating efficiencies (Werber Serafini, 9/21).

Modern Healthcare: Administration Official Says More Time Needed On Dual Eligibles
As the cost and number of dual-eligible beneficiaries continue to rise, the Obama administration's point person on this patient population told impatient senators at a hearing today that ideas for cost savings will not come until next year. "What we need right now is a little more time," Melanie Bella, director of the Medicare-Medicaid Coordination Office in HHS, said when the members of the Senate Finance Committee pressed her for concrete ideas or recommendations to lower the spiraling costs for beneficiaries who are eligible for both Medicare and Medicaid. The plea for patience in addressing a decades-old problem responsible for a growing share of federal health care costs drew bipartisan incredulity (Daly, 9/21).