Substance use is a primary concern for dually eligible individuals. Substance use conditions refer to the misuse of alcohol, illegal drugs, or prescribed medications in ways that produce harm to an individual and their environment.1 At least 60% of dually eligible individuals have three or more chronic conditions, and 41% have at least one mental health condition.2 This increases the risk of substance use conditions among dually eligible individuals.3 In addition, dually eligible individuals experience co-occurring substance use disorder (SUD) and chronic pain at rates nearly twice as high as beneficiaries with Medicare only,4 putting dually eligible beneficiaries at increased risk.
Resources for Integrated Care has developed several resources to empower providers and plans to better care for dually eligible individuals with substance use conditions.
1 McLellan A. T. (2017). Substance Misuse and Substance Use Disorders: Why do they Matter in Healthcare?. Transactions of the American Clinical and Climatological Association, 128, 112–130.
2 Centers for Medicare & Medicaid Services. “Physical and Mental Health Condition Prevalence and Comorbidity among Fee-for-Service Medicare- Medicaid Enrollees.” September 2014. Available at: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/Dual_Condition_Prevalence_Comorbidity_2014.pdf.
4 Medicare-Medicaid Coordination Office. (2016). [Memo] Opportunities for MMPs, PACE organizations, and D-SNPs to Prevent, Identify, and Treat Opioid Addiction or Misuse among Medicare-Medicaid Dually Beneficiaries. Retrieved from http://www.integratedcareresourcecenter.net/pdfs/HPMS_MMP-opioid_overutilization_10_3_16%20508%20clear.pdf.
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