Payer Insights: Future of Care for Dually Eligible Enrollees

Caring for dually eligible Medicare-Medicaid enrollees, often with complex needs, remains a significant challenge. Dual-eligible individuals frequently use home-based care, but access to the internet and technology, and availability of providers, can make home models challenging, especially in rural areas. Despite the roadblocks, innovative care models are essential to meet their unique needs. Many states are testing integrated care models to improve care and reduce costs. It is necessary to address the adoption of these models, access to care, social determinants of health (SDOH), and the current trend of dual beneficiaries enrolling in Medicare Advantage, which now serves more than half of the enrollees. Additionally, the nearly one million dual-eligible individuals living in long-stay skilled nursing facilities is further highlighting the need for improved technology and integration and its effect on patient outcomes. Let’s double our dual-eligible efforts!