Expanding Health Care Coverage

Grantee Name

Mathematica Policy Research, Inc.

Funding Area

Expanding Health Care Coverage

Publication Date

June 2015

Grant Amount


Grant Date:

December 2010 – May 2012

Individuals who qualify for both Medicare and Medicaid, known as dual eligibles, are among New York State’s costliest and most complex Medicaid beneficiaries.

Dual eligibles often require a complex array of services from multiple providers. Managed care organizations have limited experience serving this population, and individuals who are dually eligible are concerned about provider access restrictions under managed care systems. Recent developments at both the federal and State levels have provided new opportunities to coordinate care for this costly and complex population.

In 2010, NYHealth awarded a grant to Mathematica Policy Research, Inc., (Mathematica) to provide New York State with technical assistance to design a program that would integrate Medicare and Medicaid services, improve care, and reduce unnecessary spending for the dual eligible population.

Outcomes and Lessons Learned

  • Provided technical assistance to State officials and policymakers on programs serving dual eligibles in New York State;
  • Helped the State receive a $1 million planning grant from Centers for Medicare & Medicaid Services to plan and develop a program to better serve dual eligibles; and
  • Conducted an in-depth analysis for NYSDOH on long-term care options and produced the report, “Integrating Care for Dual Eligibles in New York: Issues and Options.”

After the close of this grant, New York State launched the Fully Integrated Duals Advantage program, a federal demonstration initiative to improve care for dual eligibles in New York State.