Strange Bedfellows: Coordinating Medicare and Medicaid to Achieve Cost-Effective Care for Patients with the Greatest Health Needs

Author:

Elmaleh-Sachs Arielle,Schneider Eric C.ORCID

Abstract

AbstractThis perspective describes federal efforts in the United States (U.S.) to integrate care for an especially complex, vulnerable, and costly patient population: adults eligible for both Medicare and Medicaid insurance. The goal of the paper is to demystify for clinical policy leaders and practicing clinicians the origins and evolution of the Dual-Eligible Special Needs Plans (D-SNPs) recently permanently authorized by the U.S. Congress and to explore the potential for these policy changes to help such health plans improve care for the sickest and most vulnerable Americans.

Publisher

Springer Science and Business Media LLC

Subject

Internal Medicine

Reference13 articles.

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2. Barth S, Silow-Carroll S, Reagan E, Russell M, Simmons T. Care coordination in integrated care programs serving dually eligible beneficiaries – health plan standards, challenges and evolving approaches. 2019. https://www.macpac.gov/wp-content/uploads/2019/03/Care-Coordination-in-Integrated-Care-Programs-Serving-Dually-Eligible-Beneficiaries.pdf.

3. Archibald N, Soper M, Smith L, Kruse A. Integrating care through Dual Eligible Special Needs Plans (D-SNPS): opportunities and challenges. 2019. https://aspe.hhs.gov/basic-report/integrating-care-through-dual-eligible-special-needs-plans-d-snps-opportunities-and-challenges#execsum.

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