Dual Eligible Demonstrations: Resources for Advocates - The Commonwealth Fund
Overview
In April 2011, the Centers for Medicare and Medicaid Services (CMS)
awarded $1 million grants to 15 states for the design of integrated
service delivery and payment models for
dual eligibles, people with high
health care needs who are enrolled in both Medicare and Medicaid. CMS
has emphasized that consumer stakeholders must be included in the
planning processes.
A new Commonwealth Fund–supported Web site,
http://dualsdemoadvocacy.org/,
offers educational resources for consumer groups and can serve as a
platform for sharing ideas and strategies for improving care for dual
eligibles.
The Problem
States are struggling to find ways to engage consumers in the
development of integrated models of care for people with Medicare and
Medicaid. At the same time, consumer representatives say they need
resources to help them gain a better grasp of the technical design and
implementation issues involved.
Audience
Health care consumers and state consumer advocates
The Intervention
The Web site
http://dualsdemoadvocacy.org/ is a resource for consumers and advocates that provides background information, links to news and events, and, in the
Advocate Tools
section, concrete recommendations to help advocates work with state
policymakers to ensure that new delivery models improve care for dual
eligibles. The Advocate Tools cover such topics as the development of
the appeals process if health plans or providers deny needed care;
patient assessment and care planning; consumer protections; and provider
payment models. The site also offers state-by-state information about
the dual eligibles population and the demonstration projects that local
policymakers are considering. The site also features a custom search
tool to direct users to the most valuable resources on the Web about
dual eligibles..
For More Information
Visit
http://dualsdemoadvocacy.org/.
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