The Opportunity

The Medicare-Medicaid enrollee population is a heterogeneous and unique group. They are more likely to be low-income, have a disability, and have higher rates of diabetes, pulmonary disease, stroke, Alzheimer’s disease, and serious mental illness than other populations. Unfortunately, many existing measures are not designed to account for the specific needs and care considerations of dual eligible beneficiaries. Thus, it is critical to ensure that strategies to improve the coordination and quality of care for this population rely on measures that have been designed specifically with the unique needs of the population in mind.

Overview

The MAP Dual Eligible Beneficiaries Workgroup, with oversight from the MAP Coordinating Committee, provides recommendations to the Centers for Medicare & Medicaid Services (CMS) on issues related to the quality of care for Medicare/Medicaid dual eligible beneficiaries. Additionally, the workgroup makes annual refinements to the Family of Measures for Dual Eligible Beneficiaries and explores health-related quality of life issues including patient experience and perspective.

About the Project

NQF Process

NQF will convene a multi-stakeholder group to identify appropriate quality measures, measurement gaps, and potential opportunities for future quality measurement for Medicare-Medicaid enrollees across programs and across the continuum of care. Further, the workgroup will refine the family of measures specifically applicable to Medicare-Medicaid enrollees across providers, programs and payers.

Funding

This project is funded under NQF’s contract with the Department of Health and Human Services.

Contact Information

For more information, contact Kate Buchanan 202-783-1300 or via email at mapduals@qualityforum.org.