« The Dual Agenda: October 15, 2015 Issue

Noteworthy News

Community Catalyst Joins Health Care Transformation Task Force

The Health Care Transformation Task Force, a partnership of leading health care payers, providers, purchasers and patient organizations, announced that Community Catalyst has joined its membership, and Susan Sherry, Deputy Director of Community Catalyst, has been named to serve on the group’s board. The organization will have additional representation on the Task Force’s work groups.

The Task Force is an industry consortium that brings together patients, payers, providers and purchasers to align private and public sector efforts to clear the way for a sweeping transformation of the U.S. health care system. By developing and disseminating strategy, operational and policy recommendations, it seeks to spark rapid, measurable change across the health care landscape. Its members are committed to having 75 percent of their respective businesses operating under value-based payment arrangements by 2020.

“We’re delighted to participate in the Task Force and hope to bring a valuable consumer perspective to this important work,” said Sherry. “It’s critical that the various stakeholders in the health system work together to encourage innovation and efficiency in the system without shifting additional costs onto consumers. Our ultimate collective goal has to be better care at lower costs.”

Tips for States Pursuing Integrated Care for Dual Eligibles

As the dual eligible demonstrations have gone live in eleven states across the country, it has become clear that provider support for – and engagement in – the projects is critical to their success. The Integrated Care Resource Center (ICRC) has developed a technical assistance brief that provides tips for states pursuing integrated care for their Medicare-Medicaid enrollees. The brief offers suggestions to states on how to engage providers who serve Medicare-Medicaid enrollees in managed care systems, and provides examples of effective approaches employed by states that have launched integrated care programs.

Survey on Medical Frailty Reveals Health Disparities

The Johns Hopkins Bloomberg School of Public Health has released results from a large-scale survey of older Americans living at home or in assisted living settings. The study found that 15 percent of these individuals are frail, and therefore more vulnerable to falls, chronic disease and disability, while another 45 percent are considered pre-frail, or at heightened risk of becoming physically diminished. In addition, the study found wide regional differences, with older people in southern states more than three times as likely to be frail than those in the western states. The researchers also found significant racial differences, with Blacks and Hispanics of similar age to be nearly twice as likely as whites to be frail. The study is published in the September 2015 issue of Journals of Gerontology: Medical Sciences.

Fact Sheet on California’s Integrated Care Programs

The SCAN Foundation has released a fact sheet on California’s Coordinated Care Initiative (CCI). The CCI includes three elements: the California dual eligible demonstration project; mandatory enrollment of dual eligibles into managed care; and integration of LTSS into managed care. The Initiative is now active in seven counties, and the fact sheet provides an update on a wide variety of issues, including enrollment, the enrollment timeline, administrative updates including new health plan guidance letters issued by the state, an update on health risk assessments, a budget update, outreach and education efforts, an evaluation update and a preview of issues likely to arise looking forward.

Study Questions Role of Medicare Advantage for Dual Eligibles and Other High-Need Patients

A new study in Health Affairs questions the role of Medicare Advantage plans in serving high-cost patients with complex care needs, particularly dual eligibles. The authors examined the rates at which participants switched between Medicare Advantage and traditional Medicare. They found that the switching rate away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long- or short-term nursing home care or home health care services. These results were magnified among dual eligibles.

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