Public Policy & Action

• Federal Funding for Seniors Programs
• Older Americans Act
• Long-Term Services & Supports
  • Medicaid HCBS Webinars
  • Duals Integration
• Health Care Reform
• Our Positions
• Advocacy Toolkit

Resources

For Professionals

• SNAP Food Benefits at Risk for Cuts
• House Budget Reconciliation Sets Disturbing Precedent for Seniors Programs
• Celebrate Older Americans Month by Finding Benefit Programs that Can Help You
• BenefitsCheckUp® Promotes Programs to Fight Senior Hunger During National Nutrition Month
• Missing from the Presidential Debate: Long-Term Care
• Managed Long-Term Services and Supports: Overview of Key Issues and Guiding Principles
• The Impact of Isolation on the Economic Security of Older Adults

For Older Adults and Caregivers

• Long-Term Services & Supports: Candidate Survey
• You Gave, Now Save

For Advocates

• SNAP Food Benefits at Risk for Cuts
• House Budget Reconciliation Sets Disturbing Precedent for Seniors Programs

Duals Integration

Approximately 9 million low-income seniors and younger persons with disabilities are enrolled in both Medicare and Medicaid (often referred to as “duals”), and their number is growing as the population ages.  

Close to half of all seniors and younger adults with disabilities who have Medicare as their primary health care live in poverty. That's why changing the way people with Medicare and Medicaid get access to care has become a priority for policymakers. 

The Affordable Care Act established the Medicare-Medicaid Coordination Office within the U.S. Centers for Medicare & Medicaid Services (CMS) to better align and coordinate benefits and fiscal interactions between the two programs. 

Innovative Approaches to Improve Care

Early in 2011, CMS awarded 15 states with design contracts of up to $1 million each to develop service delivery and payment models that integrate care. 

In July 2011, CMS invited states to apply for funding to create two innovative approaches that might demonstrate how to better coordinate care and lower costs for the dual population. 

CMS invited all states to propose either a capitated model involving a three-way contract among a state, managed care plan, and the federal government or a managed “fee-for-service" model in which the state and federal government contract to share savings from implementing delivery systems changes such as medical homes or Accountable Care Organizations. 

So far, a total of 37 states and the District of Columbia have submitted letters of intent to pursue this opportunity.  

NCOA's Role 

NCOA is working with federal and state aging and disability advocates—as well as benefits counseling organizations including SHIPs, AAAs, and ADRCs who are MIPPA grantees working with the target population—to ensure effective and person-centered implementation, with meaningful consumer protections as states move forward on integration efforts.

There are significant implications for beneficiary rights around enrollment choices, securing all care and services covered by Medicare and Medicaid, choice of providers and care options, quality of care and outcomes, and long-term services and supports.

Learn More

Key Issues for Advocates

• Leadership Council of Aging Organizations' Dual Eligible Principles
• NCOA and Disability Rights Education & Defense Fund Resources
• National Senior Citizens Law Center Dual Eligibles
• Friday Morning Collaborative webinar series
• Summary of Comments on Proposed Integration of Care for Medicare-Medicaid Duals  

Medicaid Managed Long-Term Services and Supports

• Examining Medicaid Managed Long-Term Services and Support Programs: Key Issues to Consider, Kaiser Family Foundation (2011)
• Roadmap for Managing Long-Term Services and Supports, Center for Health Care Strategies (2010)
• Successfully Enrolling People with Disabilities in Managed Care Plans, National Council on Disability
• CMS Managed Care NCD Recommendations, National Council on Disability

Background

• Medicaid's Role for Dual Eligible Beneficiaries, Kaiser Commission on Medicaid and the Uninsured (April 2012)
• Medicare's Role for Dual Eligible Beneficiaries, Kaiser Family Foundation (April 2012)
• Financial Alignment Models for Dual Eligibles: An Update, Kaiser Family Foundation (November 2011)
• CMS Integrated Care Resource Center

want to live in a country where

older adults don't have to choose between paying for medicine or food.