The federal government could potentially save $125 billion over 10 years if it required beneficiaries of both Medicare and Medicaid, or dual eligibles, to enroll into team-based coordinated care models, according to a report by Emory University Professor Kenneth Thorpe funded by America's Health Insurance Plans (pdf).
States could also save $34 billion over that decade, the report said. As of 2010, there were more than 9 million dual eligibles, who traditionally have higher rates of chronic illness and nursing home admissions. They account for 36 percent of total Medicare spending and 39 percent of total Medicaid spending, and in 2011, it is estimated the federal government will spend more than $230 billion on dual eligibles.
Mr. Thorpe outlined the proposal with three major points:
• All dual eligibles would be enrolled in a health plan with the opportunity to opt out.
• States can design their own models, but each model would include evidence-based functions such as preventive and transitional care.
• Health plans would be responsible for coordinating, integrating and developing all care coordination functions.
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States could also save $34 billion over that decade, the report said. As of 2010, there were more than 9 million dual eligibles, who traditionally have higher rates of chronic illness and nursing home admissions. They account for 36 percent of total Medicare spending and 39 percent of total Medicaid spending, and in 2011, it is estimated the federal government will spend more than $230 billion on dual eligibles.
Mr. Thorpe outlined the proposal with three major points:
• All dual eligibles would be enrolled in a health plan with the opportunity to opt out.
• States can design their own models, but each model would include evidence-based functions such as preventive and transitional care.
• Health plans would be responsible for coordinating, integrating and developing all care coordination functions.
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