The Center for Health Care Strategies in Hamilton, New Jersey, has announced the launch of an eighteen-month initiative that will test innovative care models for "dual eligibles" — people who are eligible for both Medicare and Medicaid — to help states determine ways to improve care while controlling costs.

Funded by the Commonwealth Fund, the Transforming Care for Dual Eligibles initiative will work with state governments in Colorado, Maryland, Massachusetts, Michigan, Pennsylvania, Texas, and Vermont to eliminate barriers to integrating Medicaid- and Medicare-covered services via Medicare Advantage Special Needs Plans. CHCS also will work with the Centers for Medicare and Medicaid Services to identify new avenues for integrating care.

While the more than eight million adults who are dually eligible represent approximately 18 percent of the Medicaid population, they account for 46 percent of the program's costs due to the range and variety of their medical, behavioral, and long-term care needs. In addition, a majority of dual eligibles are in fragmented fee-for-service systems, with little to no care coordination. According to CHCS, integrating the financing, delivery, and administration of services across Medicaid and Medicare could significantly reduce unnecessary hospitalizations and decrease the use of institutional care over time.

"As the nation looks toward reforming our healthcare system, there are significant opportunities to improve the quality and cost-effectiveness of care for people who are eligible for both Medicaid and Medicare coverage," said Commonwealth Fund president Karen Davis. "The work of these seven states in designing patient-centered delivery models for this critical, yet often overlooked, population will help pave the way for other states looking to improve care for duals."