Improving care for individuals dually eligible for Medicare and Medicaid: preliminary findings from recent evaluations of the Financial Alignment Initiative

Improving care for individuals dually eligible for Medicare and Medicaid: preliminary findings from recent evaluations of the Financial Alignment Initiative

Collection:
Health Policy and Services Research
Series Title(s):
Issue brief (Commonwealth Fund)
Author(s):
Hwang, Ann, author
Keohane, Laura M., author
Sharma, Leena, author
Contributor(s):
Commonwealth Fund, issuing body.
Publication:
[New York, N.Y.] : The Commonwealth Fund, November 2019
Language(s):
English
Format:
Text
Subject(s):
Dual MEDICAID MEDICARE Eligibility
Pilot Projects
Cost Savings
Delivery of Health Care, Integrated -- economics
Facilities and Services Utilization -- statistics & numerical data
Federal Government
Government Programs -- economics
Medicaid -- economics
Medicare -- economics
State Government
Humans
California
Illinois
Massachusetts
Ohio
Texas
United States
Genre(s):
Technical Report
Abstract:
ISSUE. The Financial Alignment Initiative (FAI) aims to improve care for individuals dually eligible for Medicare and Medicaid. Recent interim evaluations of the FAI offer important new information about the successes and limitations of these models. GOAL. Assess the findings of recent evaluations from five states to identify initial themes and lessons from the Initiative. METHODS. Review of RTI International evaluations of the FAI in California, Illinois, Massachusetts, Ohio, and Texas. KEY FINDINGS. Medicare cost saving results under the FAI are mixed. Despite the model's emphasis on care coordination, few beneficiaries reported receiving care coordination. Implementation challenges suggest the need for adequate resources and timelines. The FAI evaluations were limited by a lack of Medicaid data, particularly in the calculation of cost-savings and in assessing service utilization impacts. CONCLUSION. Efforts to integrate services and financing for dual-eligible enrollees should: ensure there are sufficient resources to support implementation by state governments and other stakeholders; include robust consumer engagement through design, implementation, and oversight stages; watch capacity and performance of plans and providers to meet the needs of a complex population; and have the ability to make midcycle corrections.
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 (7 pages))
Illustrations:
Illustrations
NLM Unique ID:
101758879 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/101758879