New York State Health Foundation

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Integrating Care for Dual Eligibles

More than 700,000 people in New York are simultaneously enrolled in both Medicare and Medicaid. These dual eligibles are among the State's costliest and most complex Medicaid beneficiaries. NYSHealth has undertaken a number of projects to inform, shape, and improve policies that will affect the health of these patients. A February 2012 NYSHealth-funded report, “Integrating Care for Dual Eligibles in New York: Issues and Options,” developed by Mathematica Policy Research, provided a comprehensive profile on: 

  • Dual eligible characteristics, care needs, costs, and service delivery options.
  • Aspects of New York's Medicaid program that present opportunities and challenges for integrated care programs for dual eligibles.
  • Integrated care program design options based on a review of programs in other states, the characteristics and care needs of dual eligibles in New York State, and feasible options based on State capabilities and potential for Federal approval.

The report offered specific recommendations for New York State as it works to improve the coordination and integration of care for dual eligibles. The NYSHealth report has been credited as the blueprint for New York State’s subsequent proposal on dual eligibles to the Centers for Medicare & Medicaid Services, which incorporated nearly all of the report’s recommendations.