Research and Markets: Population Health Management for Dual Eligibles: Blueprint for Care Coordination

<0> Research and Markets: Population Health Management for Dual Eligibles: Blueprint for Care Coordination </0>

<0> Research and MarketsLaura Wood, Senior Manager.U.S. Fax: 646-607-1907Fax (outside U.S.): +353-1-481-1716Sector: </0>

has announced the addition of the report to their offering.

Across the country, CMS is providing funding and technical support for select states to develop person-centered approaches to care coordination of dual eligibles, connecting primary, acute, behavioral health and long-term supports and services for beneficiaries of both Medicare and Medicaid.

The goal is to create care delivery and payment coordination models for this vulnerable population that can be piloted and replicated in other states.

Meanwhile, SCAN Health Plan has a history of successful care management of dual eligibles, who constitute about 9 million individuals in the United States. The not-for-profit California-based health plan has developed a multi-pronged, member-specific approach to reaching dual eligibles that has earned kudos from the healthcare industry.

Population Health Management for Dual Eligibles: Blueprint for Care Coordination details SCAN's unique care management model for duals, which focuses on prevention and early intervention, particularly in the area of medication management.

In this 27-page report, Dr. Timothy Schwab, chief medical officer, SCAN Health Plan, shares the health plan's strategic approach to serving the dual eligible market.

He provides details on the following:

- The issues and solutions for serving the dual eligible market;

- Current trends in the dual eligible marketplace;

- Developing relationships with long term care services and support providers to manage care for dual eligibles;

- Integrating acute and long term care coordination; and

- Metrics to follow in the dual eligible market.

A Results-Oriented Approach

- Dual Eligibles Care

- Defining the Duals

- Factoring in Functional Impairment

- Defining Program Goals, Metrics and Population

- The Role of Care Management

- Starting with Risk Stratification

- Considering the Home Environment

- Opportunities from Dual Eligibles

Business Opportunities Related to Dual Eligibles

- Success Stories

- Program Risks

Q&A: Ask the Experts

- SCAN Interdisciplinary Care Team

- HRAs for Health Risk Stratification

- Disability Support for Dual Eligibles

- Sources for Care Management Protocols

- Measuring the Effectiveness of Case Management

- PMPM Costs for Care Coordination

- Reducing Readmissions through Care Transition Management

- Qualifications for Care Coordinators and Managers

- Overcoming Transportation Obstacles

- Prospective Coding Assessments

- Communicating with the Medical Home

- Working with Complex Cases

- Integrating Care For Duals

- Locating Hard-to-Reach Duals

- Home Visit Guidelines and Challenges

Glossary

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About the Speakers

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