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Advisory group warns data limits complicate including Medicare‑Medicaid duals in Medicaid reform
Summary
Stakeholders advised excluding dually eligible Medicare‑Medicaid members from the initial primary‑care payment redesign because the state lacks comprehensive Medicare data and Medicare is the primary payer for primary‑care services for that population.
Advisory‑group participants spent a sustained portion of the meeting discussing whether and how to include Medicare‑Medicaid duals in any Medicaid primary‑care payment reform.
Presenter (S1) and other participants explained the practical barrier: Medicaid lacks comprehensive access to Medicare claims and encounter data, making it difficult for the state to construct…
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