1. ACAP Dual Eligibles Toolkit: Summary Data for Arizona
Compiled by: Special Needs Consulting Services (SNCS)

2. Key Information, Arizona
Arizona has roughly 100,000 “full duals”
55% of these persons are age 65+
The full duals’ annual costs (across Medicaid and Medicare) now total approximately $300 billion – roughly $50,000 per person per year
53% of these expenditures are paid for by Medicaid
SNCS estimates that 71.8% of Arizona’s duals’ costs are currently paid via capitation; 28.2% via FFS
Arizona plans to participate in CMS Capitation Alignment Demonstration, with initial enrollment effective January 2013
MCOs interested in serving duals under this demonstration need to engage in significant preparations during CY2012 (and CY2013)
Average lifetime revenue for each dual eligible enrolled is likely to approach or exceed $500,000, since most duals will remain eligible and enrolled for remainder of their lives (which should average > 10 years)
The high needs and high costs, coupled with the “rest of life” enrollment dynamic, creates profound and exciting care coordination opportunities
Moving Arizona’s duals into coordinated care also makes market positioning critically important for MCOs interested in serving this subgroup

3. Estimated PMPM Cost, Arizona Full Duals, 2008
Age <65
Age 65+
All Full Duals
Average Eligibles
46,040
55,045
101,086
Total Medicaid Cost
$799
$853
$828
Nursing Home $3
$27
$16
Capitated Care
$680
$769
$728
HCBS Waiver & Prosthetics $5
Personal Support $0
ICF/MR $-
All Other Medicaid
$112
$52
$79
Estimated Medicare Costs
$618
$861
$750
Part A
$291
$413
$358
Part B
$325
$446
$391
Part D $1 $2
Total Costs, Medicaid & Medicare
$1,417
$1,714
$1,579

4. Estimated Total Dollar Cost, Arizona Full Duals, 2008
Age <65
Age 65+
All Full Duals
Average Eligibles
46,040
55,045
101,086
Total Medicaid Cost
$441,603,772
$563,314,822
$1,004,918,594
Nursing Home
$1,832,535
$18,112,846
$19,945,381
Capitated Care
$375,458,384
$507,884,411
$883,342,795
HCBS Waiver & Prosthetics
$2,654,598
$3,084,998
$5,739,596
Personal Support
$23,074
$46,499
$69,573
ICF/MR $-
All Other Medicaid
$61,635,181
$34,186,068
$95,821,249
Estimated Medicare Costs
$341,263,047
$568,823,544
$910,086,591
Part A
$161,044,194
$272,835,648
$433,879,842
Part B
$179,613,699
$294,832,601
$474,446,300
Part D
$605,154
$1,155,295
$1,760,449
Total Costs, Medicaid & Medicare
$782,866,819
$1,132,138,366
$1,915,005,185

5. Publicly Available Resources Containing Data and/or Other Information About Arizona’s Dual Eligibles
Medicare-Medicaid Enrollee State Profile, Arizona, Centers for Medicare & Medicaid Services
Financial Models to Support State Efforts to Coordinate Care for Medicare-Medicaid Enrollees, Demonstration Proposal, Arizona
Achieving Optimal Care Coordination for Medicaid/Medicare Dual Eligibles, August 2011, Special Needs Consulting Services (Joel Menges, Jeremy Batt, Kaleigh Beronja, Jessica Wiecezak)