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Medicare Advantage insurers that miss enrolling dual-eligibles are missing an opportunity, said Change Healthcare, which has introduced a combination of artificial intelligence and behavioral science to identify candidates.
WHY THIS IS IMPORTANT
Enrolling individuals dually-eligible for Medicare and Medicaid is good business for insurers who are already in the Medicare Advantage space.
While this population has more chronic conditions, payers are reimbursed by state Medicaid benefits for the risk they take on.
For the provider, it adds to the panel of people who are now covered in the system.
This population is rising as baby boomers age. Unfortunately, some seniors may find they qualify for Medicaid if their retirement income is low enough. The guideline is 138 percent of the federal poverty level, an estimated $16,394 for an individual.