A new report by the AHIP has revealed that Medicare and Medicaid dual - eligible care models require extensive care coordination for patients with multiple chronic conditions . Currently , 12 million Americans use services from both Medicare and VA but can often struggle when attempting to access care , with their experiences becoming uncoordinated and fragmented . States can turn to three types of dual - eligible care models so as to meet the needs of members that rely on Medicare and Medicaid equally . The first of these is Dual - Eligible Special Needs Plans ( D - SNPs ) , which are Medicare Advantage plans that usually cover both Medicaid and Medicare benefits . States must determine how far the D - SNPs are allowed to go in covering the benefits , however . In the next decade though D - SNPs will be required to support greater integration between Medicare and Medicaid . In 2018 , over 1 million dual - eligible members enrolled in a D - SNP of any type . The second form of care model is Medicare - Medicaid Plans ( MMPs ) , which are provided through a CMS demonstration . These plans provide the most integrated model , with care individualized for each enrollee . MMPs are established through three - way contracts between the health plan , CMS , and a state Medicaid agency . This the newest model , with the first version launched in Massachusetts in 2014 and expanded into nine other states since . Currently , it is estimated that 383,000 dual - eligible Medicare and Medicaid beneficiaries are enrolled . The third model is Programs of All - Inclusive Care for the Elderly ( PACE ) . PACE plans are used to support beneficiaries live in the community instead of nursing homes and related facilities . Almost all PACE enrollees are dual - eligible for Medicare and Medicaid , with just over 41,000 dual - eligible beneficiaries enrolled in 2018 . 65 percent of dual - eligible beneficiaries are 65 or older and 72 percent have at least three chronic conditions . 20 percent of Medicare enrollment and 15 percent of Medicaid enrollment is accounted for by dual - eligible beneficiaries , but they are responsible for 35 percent of spending . This equates to approximately $ 235 billion in Medicare spending and $ 193 billion in Medicaid spending .
A new report by the AHIP has revealed that Medicare and Medicaid dual-eligible care models provide extensive care coordination for patients with multiple chronic conditions. Currently, 12 million Americans use services from both Medicare and Medicaid but can often struggle when attempting to access care, with their experiences becoming uncoordinated and fragmented. Payers can turn to three types of dual-eligible care models so as to meet the needs of members that rely on Medicare and Medicaid equally. The first of these is Dual-Eligible Special Needs Plans (D-SNPs), which are Medicare Advantage plans that usually cover both Medicaid and Medicare benefits. States can determine how far the D-SNPs are allowed to go in covering the benefits, however. In the next decade though D-SNPs will be required to support greater integration between Medicare and Medicaid. In 2018, over two million dual-eligible members enrolled in a D-SNP of any type. The second form of care model is Medicare-Medicaid Plans (MMPs), which are provided through a CMS demonstration. These plans provide the most integrated model, with care individualized for each enrollee. MMPs are established through three-way contracts between the health plan, CMS, and a state Medicaid agency. This the newest model, with the first version launched in Massachusetts in 2014 and expanded into nine other states since. Currently, it is estimated that 383,000 dual-eligible Medicare and Medicaid beneficiaries are enrolled. The third model is Programs of All-Inclusive Care for the Elderly (PACE). PACE plans are used to support beneficiaries live in the community instead of nursing homes and related facilities. Almost all PACE enrollees are dual-eligible for Medicare and Medicaid, with just over 41,000 dual-eligible beneficiaries enrolled in 2018. 65 percent of dual-eligible beneficiaries are 65 or older and 72 percent have at least three chronic conditions. 20 percent of Medicare enrollment and 15 percent of Medicaid enrollment is accounted for by dual-eligible beneficiaries, but they are responsible for 35 percent of spending. This equates to approximately $235 billion in Medicare spending and $193 billion in Medicaid spending.