The main variable of interest is a patient's dual eligibility
HCOs face a unique set of challenges in caring for newly eligible patients, such as minimizing or avoiding costs, working within the confines of bundled payment or shared savings models and tackling problems prevalent within low-income Medicaid populations (such as chronic disease, high emergency department usage, dual eligibility
, dual medical and behavioral diagnoses and prevention of admissions and readmissions).
Many people with dual eligibility
have complex needs because of serious chronic illnesses and disabilities, including mental illness.
As expected, almost all beneficiaries who newly acquired dual eligibility
in year 2 enrolled in the LIS (p<.
Capello (pictured below) used the example of Germany, who took 11 players to the last World Cup who had dual eligibility
- including star man Mesut Ozil and defender Serdar Tasci, both of Turkish origin.
In those cases involving dual eligibility
, individuals must meet both sets of rules to remain eligible for both benefits programs.
But this is good for Wales and Ireland because the boys still have dual eligibility
for both countries.
Enabling resources" included dual eligibility
for Medicare, Medicaid plan type (FFS versus managed care) and urban/nonurban residence (using county-level data linked via zip code algorithm to the 1999 Area Kesource Files).
If a State does not pay Medicare premiums for all dually eligible beneficiaries, using a State buy-in indicator as a proxy for dual eligibility
would result in undercounting and potentially biased estimates (Barosso, 2006; Baugh, 2004-2005).
It concluded that those low-income residents who were enrolled in a "below benchmark" drug plan as part of the program's dual eligibility
were faced with access restrictions to certain medications.
The only accommodation made for SNF residents is that individuals with dual eligibility
for Medicare and Medicaid are excused from the requirement of copayments while they are under care in an institution.
In addition, the Massachusetts legislature recently threw out a provision that allowed dual eligibility
for Medicare and Medicaid to the elderly poor.