The "One Care" Program at Commonwealth Care Alliance: partnering with Medicare and Medicaid to improve care for nonelderly dual eligibles
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Case study. Care models for high-need, high-cost patients
- Author(s):
- Klein, Sarah, author Hostetter, Sarah, author McCarthy, Douglas, author
- Contributor(s):
- Commonwealth Fund, issuing body.
- Publication:
- [New York, N.Y.] : Commonwealth Fund, December 2016
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Delivery of Health Care, Integrated Disabled Persons Dual MEDICAID MEDICARE Eligibility Long-Term Care Mental Disorders -- therapy Mental Health Services Patient Care Team Social Support Substance-Related Disorders -- therapy Community Health Services Insurance, Health, Reimbursement Humans Massachusetts United States
- Genre(s):
- Technical Report
- Abstract:
- KEY FEATURE. Interprofessional care teams provide integrated, high-touch care to patients in homes, primary care practices, and community settings, using flexible benefits that cover services not traditionally reimbursed by Medicare or Medicaid. TARGET POPULATION. Low-income adults under age 65 who are enrolled in both Medicare and Medicaid. WHY IT'S IMPORTANT. One Care: MassHealth plus Medicare is one of a few programs in the United States that seek to integrate medical, behavioral health, and social services for patients with serious mental illnesses, substance abuse problems, or debilitating disabilities. BENEFITS. After 12 months, Commonwealth Care Alliance health plan members enrolled in the One Care demonstration had 7.5 percent fewer hospital admissions and 6.4 percent fewer emergency department visits compared with the prior 12 months, and made greater use of long-term services and supports. CHALLENGES. Ensuring lump-sum payments from Medicare and Medicaid are adequate for meeting medical and nonmedical needs. Establishing community-based service networks to fill gaps in the care continuum.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (14 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101719376 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101719376