It has been seen that individuals who are qualified for both Medicaid and Medicare benefits, popularly known as the term Dual Integrated Beneficiaries, face the challenges of operating between the two programs. For them, an integrated dual-eligible program MAPAC has been asserted for their service.
- MACPAC based its recommendations on its work of two companies that have advocated for a better, Medicare-Medicaid integration – Dual-Eligible coalition and the Bipartisan Policy Center(BPC). According to a report by MACPA, given that Medicare and Medicaid are administered and financed differently and were designed to accomplish different goals, the ability to fully integrate is difficult”.
- The MACPAC report recommended that Congress would have to address six key areas for integration: qualification, beneficiary protections, registration, compensations, delivery system, care coordination administration, and funding.
- In the commission’s view, a unified program designed specifically for the dually eligible population has the potential to address the fragmentation and the poor outcomes that result from having two uncoordinated programs, the report said. Despite the complexities faces, MACPAC declared the need for a unified solution for dual eligibles.
- This new model could ascertain a shared program through medicare savings. It could also involve risk alleviation through Risk Corridors. Policymakers would also have to identify levels of funding directed to each state.
- Policymakers would first have to discover who would be eligible for qualifying for this program. Medicare Eligibility standards are mundane and available to all, but Medicaid eligibility criteria vary from state to state. Both BPC and Dual Eligible Coalition recommend continuous eligibility for 12 months. Currently, Medicaid must provide constant eligibility coverage during the pandemic. At the end of the waiver, the procurement will also terminate.