As a former Chief Medical Officer of a Medicare Advantage plan that focused on covering underserved secondary markets, inclduing dual elgibibles and "Special Needs" members, I can attest to the significant needs of dual eligible individuals. When done properly, the careful management of ALL of the individuals needs, not only from a conventional medical coverage standpoint, but also from the social needs standpoint, can markedly improve the quality of life and health that these individuals experience. This also comes at a reduced cost. A significant, and unresolved challenge however may well be the level of access to care for these individuals whan moving form an unmanaged fee for service model to a managed care model. To do it right takes an extraordinary amount of comprehensive care management focusing on all of the needs of the individual.