Tag Archives: dual eligibles

Policy experts predicted AHCA’s potential impact on older adults

Photo: Andy De via Flickr

From higher age-based premiums to cuts in Medicaid funding for dual eligibles, there was much for aging advocates to criticize about the Republicans’ now-failed attempt to repeal and replace the Affordable Care Act (ACA).

Policy experts from several aging advocacy organizations briefed reporters during a March 23 conference call on the proposed American Health Care Act (ACHA). The next day, GOP leadership and the White House decided to pull the amended bill from consideration due to lack of support in the House of Representatives.

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Report: Integrated care improves outcomes for those using both Medicare, Medicaid

GraphicStock

GraphicStock

It almost seems like a no-brainer that dovetailing care between Medicare and Medicaid will have positive effects on the population of dual-eligible older adults.

In reality, care and payment under these systems is often fragmented and disjointed, a frustrating scenario for primary care providers and detrimental to patients. A new report  from the Centers for Medicare and Medicaid (CMS) on The Minnesota Senior Health Options (MSHO) program reinforces the need for improved service coordination. Continue reading

Finding fresh ways to report on Medicaid, changes in health care system

Photo: Phil GalewitzA recent AHCJ chapter meeting featured discussion of Medicaid and story ideas for reporters to pursue. Facing the camera, from left to right, are Rebecca Adams of CQ Roll Call, Joan Alker of the Georgetown Center for Children and Families; Cindy Mann, former head of Medicaid official; and Matt Salo, head of the National Association of Medicaid Directors.

Photo: Phil GalewitzA recent AHCJ chapter meeting featured discussion of Medicaid and story ideas for reporters to pursue. Facing the camera, from left to right, are Rebecca Adams of CQ Roll Call, Joan Alker of the Georgetown Center for Children and Families; Cindy Mann, former head of Medicaid official; and Matt Salo, head of the National Association of Medicaid Directors.

The Washington, D.C., chapter of AHCJ held an event about Medicaid in late October with Matt Salo, who leads the National Association of Medicaid Directors; Cindy Mann, who until January was the top U.S. official in charge of Medicaid at HHS and now works at Manatt, Phelps & Phillips; and Joan Alker, executive director of the Georgetown Center for Children and Families.

Here are some of their insights and story ideas that can help reporters keep this story fresh. Continue reading

Report examines Medicaid’s role in community-based care for dual eligibles

Photo: Eric Ward via Flickr

Photo: Eric Ward via Flickr

Some low-income seniors who qualify for both Medicare and Medicaid — the dual eligibles — have the chance to age in place in their communities thanks to Medicaid’s coverage of long term services and supports (LTSS). This is especially important for older adults who are juggling multiple chronic conditions and may require help with activities of daily living, like bathing, dressing, or eating.

This is a population at high risk for needing expensive institutional care, and is not the preferred site of care for most people. Community-based LTSS avoids institutionalizing many older adults and is a more cost-effective solution to the growing aging population. Continue reading

Focus on Medicaid as budget debates escalate

Don’t forget about Medicaid as the budget debate occupies center stage in Washington.

Howard Gleckman reminds us why this is so important in a chock-full-of-data blog post at Forbes. I give Gleckman a boatload of credit. He’s one of the few reporters who consistently writes about vulnerable older people – a population that gets far too little attention.

Judith GrahamJudith Graham (@judith_graham), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society.

If you have questions or suggestions for future resources on the topic, please send them to judith@healthjournalism.org.

Among the key points in his post: Two-thirds of Medicaid budgets are spent on frail older people and young people with disabilities. One-third of budgets, about $120 billion in total, goes to long-term care.

Older people covered by Medicaid are poor and, many of them, dependent and chronically ill. About 9 million people known as “dual eligibles” are covered by Medicaid and Medicare, and this is a very vulnerable population, Gleckman observes:

According to the Kaiser Family Foundation, one-quarter of elderly who are eligible for both programs need assistance with at least three activities of daily living (such as bathing, going to the bathroom, eating, or dressing). Many are, in other words, helpless.

“Among the 1 million dual eligibles who are the most costly Medicaid patients, nearly half are aged 80 or older, three-quarters need help with 3 or more activities of daily living, three-quarters live in institutions, and one out of every six has Alzheimer’s.”

“Ninety percent are poor or near-poor. More than half have incomes of less than $10,000.”

Many politicians discussing cuts don’t really understand how Medicaid works or who it covers, Gleckman notes. You can be sure this is as true of your state legislators as it is of those in Congress. Continue reading