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This content was paid for by an advertiser and created in collaboration with Crain's Custom Content.
March 03, 2014 11:00 PM

Best Practices to Manage Dual Eligibles

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    Dual Eligibiles have a voice and your quality ratings are at stake. According to the Kaiser Foundation over 9.6 million seniors and younger people with significant disabilities are dually eligible for Medicare and Medicaid programs. Annually, the federal government spends over $300 billion to provide healthcare for dual eligibles. As major consumers of healthcare services, dual eligibles typically represent a chronically ill population that requires care services from several doctors, specialists and home and community service providers. The complexities of their care combined with their social and economic status present a number of challenges. Examples of these chanllenges for health plans include underperforming on quality benchmarks related to NCQA Healthcare Effectiveness Data and Information Set (HEDIS) Scores and CMS Five-Star Ratings. With healthcare reform, policy changes, quality incentives, and rising healthcare costs, health plans should have strategies for improvements to care coordination, communication of benefits and access to services.

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    • News
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      • Transformation
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        • Midwest
        • Northeast
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    • Blogs
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      • HIMSS 2023
    • Opinion
      • Breaking Bias
      • Commentaries
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - AI and Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
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