Association for Community Affiliated Plans; Medicaid Health Plans of America

This study addresses two questions. First, what are the financial implications of enrolling the dual eligible population into the capitated/integrated MCO setting on a comprehensive scale? This report estimates the cost impacts of serving dual eligibles in the capitated setting in each state across a fifteen year timeframe, demonstrating the impacts on Medicaid and Medicare spending, state and federal spending, and overall taxpayer outlays across the two programs.

Second, what are the key program design features and public policy issues that need to be addressed to achieve substantially larger-scale use of the capitated model for the dual eligible population? The report describes the barriers that have prevented more widespread enrollment of dual eligibles into MCOs, and outlines the specific policy-making opportunities to overcome these barriers.

"Throughout the engagement, Lewin consultants listened to us and delivered superb analyses and thoughtful guidance–not canned solutions."  NONPROFIT HEALTH SYSTEM