Alternate Payment Models to Increase Equity for Dually Eligible People

Medicare beneficiaries that are dually enrolled in Medicare (duals) are more likely to have social determinants of health (SODH) that are associated with poorer outcomes and decreased access to healthcare than non-duals. In addition, they have less access to novel accountable care organizations (ACOs). A new Health Access article by Karen E. Joynt Maddox and Kenton J. Johnston explores how increasing duals’ access to ACOs could help address their health disparities.

According to the authors, “we argue that the Centers for Medicare and Medicaid Services (CMS) should take action within its quality measurement and incentive programs to remedy such inequities by updating current incentive structures within Medicare that disincentivize care of duals and to instead reward clinicians and health systems for providing high-quality care to this population.“

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(Source: Health Affairs, May 9^th, 2022)