This April 2017 report, produced by The Bi-Partisan Policy Center, outlines the barriers to the integration of clinical health and social services and issues recommendations to eliminate those barriers for the Medicare-only population. A panel of experts from both the health care world and the aging and disability networks was presented at an event on April 25th, 2017 to coincide with the report’s release.
Clinical evidence suggests that frail and chronically ill Medicare beneficiaries who are not dually eligible for full Medicaid benefits could often greatly benefit from the integration of non-Medicare-covered social supports into the medical care model offered to them in the Medicare program. For instance, non-Medicare-covered support services, many of which are delivered by community-based organizations (CBOs), such as in-home meal delivery, non-emergent transportation to medical appointments, and targeted case management services have demonstrated the propensity for reducing the need for avoidable hospitalizations.
However, Medicare’s payment rules and regulations have created significant care integration barriers for Medicare Advantage (MA) plans and health care provider groups, such as Accountable Care Organizations (ACOs) and patient-centered medical homes, which would otherwise furnish and finance these non-Medicare-covered supports and services.
Read this invaluable report to learn about the role of social supports in the Medicare landscape, and how CBOs might play a larger role in new models in the future.
View the resource: Improving Care for High-Need, High-Cost Medicare Patients