New Frontiers in Community Living: National Perspectives About the CMS Launch of the Demonstration Project for Younger Medicaid / Medicare Dually Eligible Beneficiaries

In January 2013, CMS will launch the first integrated care and financing strategies for younger dually eligible Medicaid/Medicare beneficiaries. This complex set of almost 4M under-65 year old individuals with disabilities; they include some of the most expensive Medicaid andMedicare recipients. This talk will describe the demographic, health status, and health expenditure profiles of this very heterogeneous population and summarize the rationales for restructuring their care and financing. Prior Medicaid and Medicare managed and integrated care and financing efforts will provide a basis for considering the opportunities and challenges in successfully achieving the objectives of improved community-based care access, improved health status and outcomes, and reduced overall costs. Characteristics of the proposed demonstrations will be reviewed relative to their likely contribution to these outcomes and their potential problems.