With its State Demonstrations to Integrate Care for Dual Eligible Individuals, CMS has solidified its commitment to design new approaches to better coordinate care for dual eligible individuals the estimated 9 million Americans eligible for both Medicare and Medicaid.
Many initiatives are aimed at defragmenting care of the duals population, but as Camden Group President Steven Valentine cautioned during HIN's Healthcare Trends & Forecasts 2014 planning session: "Dual eligibles are extremely difficult to manage; they are often non-compliant patients. Unless you manage care really well, being in a dual-eligible managed care system will probably cost you money."
For organizations wishing to adequately prepare for the challenge of dual eligibles care management, the Guide to Dual Eligibles Care Coordination: Population Health Management for Medicare-Medicaid Beneficiaries provides the principles of a comprehensive care coordination effort for Medicare-Medicaid beneficiaries, taking into account the medical, behavioral, social and functional needs of this vulnerable population.
This 100-page guide delivers the following:
- A comprehensive set of 2013 dual eligibles care coordination benchmarks from 72 healthcare organization;
- An examination of SCAN Health Plan's unique care management model for duals, which focuses on prevention and early intervention;
- A case study of WellCare Health Plan's community-based approach to duals care coordination a healthy mix of public health and social support to connect the dually eligible to essential health services.
Download the executive summary of the Guide to Dual Eligibles Care Coordination: Population Health Management for Medicare-Medicaid Beneficiaries .
Answers to dozens of critical FAQs on care coordination for Medicare-Medicaid beneficiares are provided.
Chapter 1: 2013 Healthcare Benchmarks in Dual Eligibles Care Coordination
Chapter 2: Population Health Management for Duals
Chapter 3: Community Care Connections for Dual Eligibles
A thorough study of the metrics and case studies contained in the Guide to Dual Eligibles Care Coordination: Population Health Management for Medicare-Medicaid Beneficiaries
will prepare healthcare organizations to better serve Medicare-Medicaid beneficiaries.