November 2008

Increasing Use of the Capitated Model for Dual Eligibles: Cost Savings Estimates & Public Policy Opportunities

Researchers from The Lewin Group sought to assess two questions: the financial implications of enrolling the dual eligible population into the capitated/integrated managed care organization setting on a comprehensive scale and the program design features and public policy issues to achieve larger-scale use of the capitated model for the dual eligible population. The researchers consulted data from the federal Centers for Medicare and Medicaid Services. They noted that due to the separate administration and accountability of the programs, the total cost of dual eligibles across Medicare and Medicaid and state and federal spending, the total cost of providing services for this group of individuals is seldom tallied.