Duals demystified: Actions to drive quality, outcomes, and value for the dual eligible population

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State and federal stakeholders are sharpening their focus on the dual eligible population. What will it take to improve quality, outcomes, and value for this population?

Individuals dually eligible for Medicare and Medicaid represent only 10 percent of the population across both programs, but nearly a third of total spending. The past five years have seen a proliferation of products and programs to manage care and, in some cases, integrate benefits for the dual eligible population. In late 2018, the Centers for Medicare & Medicaid Services renewed its support for these programs and offered to assist states in navigating this complex space.

Nevertheless, while there is wide recognition of the importance of improving quality and outcomes for the roughly 12 million individuals enrolled in both Medicare and Medicaid, there is limited consensus on the most effective way to manage care for this population, or the incremental value of integrating benefits across the two programs.

In this infographic, we explore the diverse care needs and spending patterns among dually eligible individuals and opportunities for healthcare stakeholders to improve care.

The authors would like to thank Lisa Crystal, Katherine Linzer, Dan Jamieson, and Stephanie Carlton for their contributions to this article.