双重资格的医疗保险和医疗补助:两赔一还是双重危险?

NHPF issue brief Pub Date : 2003-09-30
Jennifer Ryan, Nora Super
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引用次数: 0

摘要

这个问题简要描述了被称为“双重资格”的个人人口的特征,他们有资格通过医疗保险和医疗补助获得健康保险。它还研究了“完全医疗补助”和“补充医疗补助”双重资格之间的差异,以及与登记和资格、整合和协调以及管理式医疗相关的持续挑战。本文介绍了几个旨在更好地为双重资格人群服务的综合护理项目的例子,包括老年人全包护理项目、Evercare、社会健康维护组织和州/联邦倡议,如威斯康星州伙伴计划、德克萨斯州STAR+PLUS等。最后,它考虑了众议院和参议院医疗保险处方药提案的双重资格的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dually eligible for Medicare and Medicaid: two for one or double jeopardy?

This issue brief describes the characteristics of the population of individuals known as "dual eligibles," who are eligible for health insurance coverage through both Medicare and Medicaid. It also looks at the differences between "full Medicaid" and "supplemental Medicaid" dual eligibles and the ongoing challenges associated with enrollment and eligibility, integration and coordination, and managed care. The paper presents several examples of integrated care programs designed to better serve the dual-eligible population, including the Program of All-Inclusive Care for the Elderly, Evercare, social health maintenance organizations, and state/federal initiatives such as the Wisconsin Partnership Program, Texas STAR+PLUS, and others. Finally, it considers the implications for dual eligibles of the House and Senate Medicare prescription drug proposals.

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