Eligible is a modern retelling of Pride and Prejudice seen through the eyes of the five Bennet sisters and their complex journeys to finding love in its many traditional and non-traditional incarnations. When Liz Bennett is compelled to return home, she finds herself not only thrust back into the humorous lives and unearthed secrets of her large family but also — against her better judgment — falling for the handsome and mysterious Darcy, a man who could prove to be either her salvation or undoing.
Status: In Development
Runtime: 60 minutes
Eligible - Medicare dual eligible - Netflix
Dual-eligible beneficiaries (Medicare dual eligibles or “duals”) refers to those qualifying for both Medicare and Medicaid benefits. In the United States, approximately 9.2 million people are eligible for “dual” status spending an estimated $319.5 billion in 2011 alone. Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately 36% of Medicaid expenditures. Similarly, duals total 20% of Medicare enrollment, and spend 31% of Medicare dollars. Dual-eligibles are often in poorer health and require more care compared with other Medicare and Medicaid beneficiaries. The reason that the cost for dual-eligible long-term care is high is that duals are a complex population with a complex set of needs. As a result, a one-size-fits-all approach for duals is not possible.
Eligible - Efforts to integrate Medicare and Medicaid benefits - Netflix
Dual-eligibles typically receive their Medicare and Medicaid benefits through each program separately. For Medicare benefits, beneficiaries may opt to enroll in Medicare's traditional fee-for-service (FFS) program or in a private Medicare Advantage (MA) plan (Medicare Part C), which is administered by a Managed Care Organization (MCO), under contract with the Centers for Medicare & Medicaid Services (CMS), the agency in the Department of Health and Human Services that administers the Medicare program and oversees state Medicaid programs. In addition, dual-eligibles may choose a type of MA plan called a dual-eligible special needs plan (D-SNP), which is designed to target the needs of this population. For Medicaid benefits, beneficiaries generally enroll in their state's Medicaid FFS program or a Medicaid managed care plan administered by an MCO under contract with the state. Recently, Congress and CMS have placed greater emphasis on the coordination and integration of Medicare and Medicaid benefits for dual-eligible beneficiaries. For example, the Medicare Improvements for Patients and Providers Act of 2008 required D-SNPs to contract with state Medicaid agencies to provide Medicaid benefits. More recently, the Affordable Care Act (ACA) established a type of D-SNP, referred to as a Fully Integrated Dual Eligible (FIDE) SNP, which—unlike other D-SNPs—is designed to integrate program benefits for dual-eligible beneficiaries through a single managed care organization, although payment is generally provided separately by each program. In 2011, CMS announced a financial alignment demonstration that is intended to further integrate the programs' services. CMS expects that the demonstration will decrease incentives for cost shifting and increase care coordination, resulting in improved care for beneficiaries and savings to Medicare and Medicaid. CMS projects that approximately 61 to 75 percent of savings will come from reductions in costly Medicare-covered services.
Eligible - References - Netflix