« The Dual Agenda: December 4, 2014 Issue

Noteworthy News

New Report Links High Quality Care Coordination to Improved Health and Lower Costs

A blog post by Bruce Chernoff, President and CEO of the SCAN Foundation, discusses a new report by Avalere Health that outlines how using non-medical data can potentially lower costs while improving the health of high-risk Medicare beneficiaries. The Alavere report confirms that Medicare recipients with nonmedical problems are more likely to use expensive health care interventions. Alavere looked specifically at how health risk assessments, which Medicare Advantage plans now administer, can be used to provide a fuller picture of a beneficiary’s daily life. Alavere’s analysis concludes that when high quality care coordination and transition plans are used, the quality of care and the quality of life improves for vulnerable beneficiaries. This in turn reduces the use of high-cost medical interventions.

Care Coordination Lauded in Study of Medigap Patients

A report from Mercer discusses the findings of a study of a subset of the Medigap population. This population, which purchases private Medigap coverage beyond their Medicare benefits, is generally higher income than the dual eligible population. Nonetheless, the study results may be relevant to the duals population, as well. The study, a joint project of AARP Services and UnitedHealthcare, began in 2008 and focused on complex Medicare beneficiaries, or those with multiple chronic conditions and/or life threatening diseases. Patients were assigned a team of care givers that included nurses, social workers, and behavioral health specialists, as well as doctors. The team focused on care coordination and navigation, not just medical treatment. They found that savings were most likely to be achieved among patients receiving intensive care coordination and depression management interventions. The study also showed that beneficiaries wanted as much help with nonmedical needs as they did with medical needs, and higher patient satisfaction was reported when plans focused on delivering care that met both sets of needs.

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