Health benefits could be combined for elderly low income

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LANSING — Although the state could move dual-eligible Medicare and Medicaid individuals into a new system, most beneficiaries don’t realize the potential changes to their benefits, according to a new survey.

Michigan is one of 15 states awarded a contract to develop an integrated plan that offers both high-quality and cost-effective care.

Medicare provides health benefits to people older than 65, and Medicaid benefits are for low-income residents. People who are eligible for both are called “dual eligible,” according to the Department of Community Health.

If fully implemented, the program as proposed would integrate services and funding for more than 200,000 state residents enrolled in both programs, which cost the state and federal governments more than $8 billion annually, according to the department.

Nearly 75 percent of participants said that they were “extremely” or “very” concerned that they might be forced to change health care providers. Only 3 percent said they were “not concerned,” according to a survey by the Insyght Institute.

The purposes of the program are to improve healthy outcomes and cost effectiveness, according to the Department of Community Health.

Jim Burgess, 70, of Lansing, said he knew about changes made at the federal level to these programs. However, he didn’t know exactly what kinds of benefits he would receive if the proposal is approved. “Related departments should explain it more clearly and directly,” he said in an interview at Haslett Senior Center.

According to Community Health, eligible individuals would be automatically enrolled in the integrated system unless they choose one program or the other.

Karen Holcomb-Merrill, policy director of the Michigan League for Human Services, said, “Services must be improved and coordinated for this population without creating a new bureaucracy.”

It is also critical to develop electronic health records and effective electronic communications among providers to ensure people involved in a person’s care know what treatments or medications are being prescribed, she said.

“Enrollees must have access to needed care whenever they need it, and must be assured that the right care is provided at the right time in the right place by the right provider,” Holcomb-Merrill said.

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