How Competitive Private Plans Can Improve Care for Dual-Eligible Beneficiaries of Medicare and Medicaid
by Jonathan Crowe
The Heritage Foundation
July 11, 2014
Patient-centered, market-based health reforms can help to heal the fractured incentive structure surrounding “dual eligibles,” the low-income patients who are covered under both Medicare and Medicaid. Dual eligibles must often negotiate a bureaucratic maze to receive care, but competitive health plans like Medicare Part D and Medicare Advantage have already greatly benefited them. Real Medicare reform based on expanded choice and competition can translate that achievement into better care for 9 million patients known as dual-eligible beneficiaries. Policymakers can build on the success of competitive Medicare programs by including these patients in a flexible Medicare defined-contribution (“premium support”) financing system where dual eligibles, with assistance from their families or counselors, can take advantage of care coordination provided by competing health plans.