Debt Panel thinks about dual Medicare/Medicaid patients

Rate this post

Government health benefits for over  9 million people,  who belongs to the sickest and poorest U.S. populations is going to come under inspection from the congressional “super committee”, which seeks  to cut the nation’s debt.

Some Americans qualified both for Medicare and Medicaid programs for the elderly and the poor.  The qualification based upon their disability, age and low income.

The bureaucratic parlance refers to them as “dual-eligibles”.  Both Democrats and Republicans understand that caring plays a key role in savings. The super committee panel, with six members from each party, is taking a look at suggestions in reducing spending on this group, as said by a congressional aide.

Medicare and Medicaid use around $300 billion a year for dual-eligibles, about half of whom are under therapy for five or more recurring conditions like diabetes and hypertension.

While stopping either Medicare or Medicaid does not help much from the higher proportion of cost for dual-eligibles, and their status, make it an easier part for the two parties so that they could agree on something.

Both patients represent around 15 percent of enrollees in Medicaid; however, account for 39 percent of program expenditures. They also make up 16 percent of Medicare enrollees and 27 percent of program expenses.

President Barack Obama proposes shifting federal drug reimbursements for this group so that they could lower Medicaid rates rather than compensating the higher Medicare prices, a move that got opposed by the pharmaceutical industry.

Insurance companies and states want to change policy to encourage more use of managed care, which would in, turn encourage takes away costly forms of cure, from closer scrutiny on the need for  services to incentives for protective care.

Obama’s healthcare renovation gives way to a new office that is inside the federal Center for Medicare and Medicaid Services, which develops cost-saving models of managed care.

Head of the new office, Melanie Bella believes that it would take time before savings got realized.  She shared the information last week with the Senate Finance Committee.

Cash-strapped states want more of the power that could put dual-eligibles into managed care planning. They got the support of the National Association of Medicaid Directors and officials inside the insurance industry.

Emory University professor Ken Thorpe, in a report sponsored by America’s Health Insurance Plans, explained that more than $125 billion could be saved if all dual-eligibles got placed in managed care.

Democrats and some healthcare advocacy groups say they do not like forcing people into managed care plans managed by a private insurance industry, which has reaped billions in profits without the improvement in medical care, as well as reduce costs.