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Dual Eligibles

Dual eligibles are individuals who receive both Medicare and Medicaid coverage.  There are currently approximately 9 million dual eligibles across the country.  This complex population accounts for about 15 percent of all Medicaid enrollees but 40 percent of total Medicaid spending.  In the current system, care delivered to Medicare-Medicaid patients is disjointed with each program responsible for providing different parts of the patients' care.  This also results in financial misalignment which has stymied efforts to implement care coordination for this population.  Recognizing the need to better integrate and coordinate care provided to dual eligibles, the Center for Medicare and Medicaid Innovation (CMMI) within the Centers for Medicare and Medicaid Services (CMS) has proposed several demonstration projects aimed at better aligning the financing and delivery of care provided to this population.

For more information please contact Kai Sternstein, JD, Director.

State Proposals: State Demonstrations to Integrate Care for Dual Eligible Individuals
State Proposals: Financial Alignment Demonstration Proposals
ARC resources
Other Information