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The "One Care" Program at Commonwealth Care Alliance: partnering with Medicare and Medicaid to improve care for nonelderly dual eligibles

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)
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)