A new study by Ken Thorpe examines the health care quality and savings potential of health plans and other care coordination models for Medicare/Medicaid dual eligibles. (You can find a one page summary here.)
Professor Thorpe examines past research findings that document the potential savings of specific strategies used by health plans and other coordinated care models, such as: reducing preventable hospital admissions and readmissions through coordinated transitional care; using health coaching and patient education to help patients achieve the goals in personalized care plans developed by their providers; and improving medication adherence for chronically ill patients through medication therapy management.
The paper concludes that “expanded reliance on health plans and other coordinated care approaches for dually eligible beneficiaries can achieve significant savings while improving quality of care.” It further states: “Policymakers should seriously consider greater reliance on these strategies as action on deficit reduction initiatives moves forward.”
In addition to the above study, please find more information on health plans programs and tools in use to promote care coordination as well as how these programs are helping keep patients out of the hospital and avoid potentially harmful complications.
- Innovation Reports: Health insurance plans have created many innovative programs to improve the quality of care and help patients navigate the health care system.
- Preventing Hospital Readmissions: The most recent AHIP studies on hospital readmissions found that compared to fee-for-service Medicare, Medicare Advantage plans reduced emergency room visits by 24 percent, hospital readmissions by 39 percent, certain potentially avoidable hospital admissions by 10 percent, and inpatient hospital days by 20 percent.
