About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline

LOG IN
LOG IN


1 1 (July 26, 2001)

handle is hein.crs/crsahre0001 and id is 1 raw text is: Order Code RS20973 July 26, 2001 Federal and State Initiatives to Integrate Acute and Long-Term Care Edward Alan Miller Analyst in Social Legislation Domestic Social Policy Division Summary Congress has considered many approaches to improve the financing and delivery of long-term care services to vulnerable populations. These approaches have included ways to improve the delivery of care to persons who qualify for both Medicare and Medicaid acute and long-term care services, or dual eligibles. Because persons who are dual eligibles are especially vulnerable and costly, both the federal and state governments are interested in finding more effective ways of serving them. This report characterizes the dually eligible population and describes the problems associated with meeting their health and social service needs. It briefly describes federal and state programs that seek to integrate acute and long-term care services for this population. Policy implications are also discussed. This report summarizes the more in-depth CRS Report RL30813, Federal and State Initiatives to Integrate Acute and Long-Term Care: Issues & Profiles and will not be updated. Dual Eligibles Defined Over the past two decades, Congress has considered a variety of proposals to improve the financing and delivery of long-term care. One such approach is to better coordinate the acute and long-term care services needed by many of the 7 million Medicare beneficiaries who also qualify for Medicaid (i.e., the dual eligibles). Compared to other beneficiaries, dual eligibles are especially vulnerable and costly to serve. Not only are they disproportionately poor, but they are more likely than other Medicare beneficiaries to be age 85 or older, disabled, non-white, female, living alone, in only fair or poor health, cognitively and functionally impaired, and/or suffering from many chronic ailments and diseases (see Table 1). Not surprisingly, dual eligibles use a disproportionate share of resources relative to their numbers. Although they constituted only 16% of Medicare beneficiaries in 1995, dual eligibles accounted for approximately 30% of total Medicare expenditures ($53 Congressional Research Service CRS Report for Congress Received through the CRS Web The Library of Congress