Controlling Costs and Improving Care for Dual Eligibles in New York State

Individuals who qualify for both Medicare and Medicaid, known as dual eligibles, are among New York State’s costliest and most complex Medicaid beneficiaries.

Dual eligibles often require a complex array of services from multiple providers. Managed care organizations have limited experience serving this population, and individuals who are dually eligible are concerned about provider access restrictions under managed care systems. Recent developments at both the federal and State levels have provided new opportunities to coordinate care for this costly and complex population.

In 2010, NYHealth awarded a grant to Mathematica Policy Research, Inc., (Mathematica) to provide New York State with technical assistance to design a program that would integrate Medicare and Medicaid services, improve care, and reduce unnecessary spending for the dual eligible population.