Beneficiary Protections Central to a Meaningfully Integrated Coverage and Care Experience for Individuals Who Are Dual Eligible

Back to Resources
ATIWork
08/08/2023
AUTHOR – ATI Advisory

With support from Arnold Ventures, ATI Advisory conducted listening sessions, focus groups, and interviews with diverse stakeholders to better understand the unique needs and experiences of individuals who are dual eligible for Medicare and Medicaid, and their caregivers. Through these conversations, ATI gained insights on the potential role that integrated coverage and care experiences can play in addressing the concerns of individuals who are dual eligible and their caregivers. Central to what we heard: individuals who are dual eligible and their caregivers seek a person-centered and seamless consumer experience.

In this policy brief, we include specific comments from individuals who are dual eligible and their caregivers. Where available, we have identified policy and program considerations responsive to the feedback. We have also included a one-page summary of the key challenges we hard dual eligible individuals face when accessing care.

Recent Work

Work

A Look at PACE Growth by the Numbers: States, Organizations, and Enrollment

Our primer on the Program of All-Inclusive Care for the Elderly (PACE) – a capitated health plan that provides comprehensive Medicare and Medicaid covered services to frail, older adults in the community who are eligible for nursing home care – explores the latest enrollment trends and highlights latest opportunities for PACE growth.
Read More Read More
Work

Opportunities for Improving Access to Palliative Care for Dual Eligible Individuals with Serious Illness

10% of dual eligible individuals report living with a serious illness, according to ATI Advisory’s (ATI) analysis of the 2018-2021 Medicare Current Beneficiary Survey (MCBS) using a narrow definition of serious illness. While this means that 10% of dual eligible individuals can potentially benefit from palliative care, much fewer actually receive such services. This brief highlights opportunities to promote access to palliative care for dual eligible individuals.
Read More Read More
Work

Health Equity Perspectives from Individuals Experiencing LTSS Needs, and their Caregivers, from Historically Marginalized Communities

ATI Advisory’s qualitative research highlights the experiences of individuals with long-term services and supports (LTSS) needs and their caregivers in requesting, receiving, and providing LTSS. Using a community-based participatory framework in partnership with local organizations, ATI conducted six focus groups interviewing individuals and caregivers from key populations across race, ethnicity, language ability, gender identity, sexual orientation, and disability status about their experiences with LTSS. Discussions generated themes around barriers to accessing LTSS, insights on family and professional caregiving across cultures, financial constraints, the value of social community for individuals and their caregivers, and the impacts of equitable and inequitable LTSS. This work was supported by the Robert Wood Johnson Foundation.
Read More Read More
See more Work
Share
LinkedIn / /