Dual-Eligibles are patients who are covered under both Medicare and Medicaid.
There are special programs to encourage them to enroll in Medicare Advantage.
The government pays more for you to care for them then they do for beneficiaries who are eligible for Medicare for different reasons.
They usually have a greater disease burden, making them especially lucrative for the clinician who cares for them. Remember, the sicker the patient, the more revenue you can generate for yourself as you give them great care.
Given their poor compliance, they also have the potential to cost you a lot of money.
When one comes on your panel, be especially assertive about getting them in, introducing them to your care systems.
If you find one of them drops off your panel, give them one call. This population is especially vulnerable to “slamming,” that is the illegal changing of PCPs or plans without their permission.
If you find they’ve been slammed, help them fix it. They’ll be bonded with your for life.
If they don’t, let them walk away. Make no effort to keep them. Put them on a list. If they show up on your panel again, speak to your insurance liaison and let them know of their non-compliance and that you don’t want them on your panel again.
This is not cherry picking, these patients left you on their own free will. You have no duty to accept them if they return.
This system will do more to control your costs than any medical care you can deliver to any of your patients.
Use it and thrive.