Can states develop programs to improve care for Medicare-Medicaid “dual eligible” enrollees—who have the most intensive and costly health needs—and, at the same time, save money? That is the gamble to be played out in a mammoth, multistate, federal demonstration program under the Affordable Care Act. With the re-election of President Obama, this large-scale experiment in healthcare delivery is likely to forge ahead—and it’s important to understand what is at stake.
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