This Week's Challenge: The approximately 9 million low-income elderly and disabled individuals who are Medicare and Medicaid dual eligibles are poorer and sicker than Medicare and Medicaid beneficiaries as a whole, and consequently account for disproportionate shares of Medicaid and Medicare spending, according to a study by the Kaiser Commission on Medicaid and the Uninsured. With a long history in serving Medicare beneficiaries, SCAN Health Plan has a multi-pronged, strategic approach to reaching dual eligibles based on the specific needs of the member. We wanted to illustrate SCAN's five critical links in care coordination for the dual eligible population.
Click here to view a printable version of the chart.
What We Learned: "The critical key in care coordination is developing a link between the social and the medical. It's incorporating the traditional things like disease management, utilization management, transition management and complex care management. All of these are very critical and interrelated. Critical in the dual eligible population is what happens in the home and a model can help identify that. The social and home environment impacts everything the compliance with medications and the medical advice of the physician. It deals with nutrition and transportation issues. If the patient lives in an area where they have no access to transportation, you have to be able to provide them with a means of transportation."
Dr. Timothy Schwab, chief medical officer of SCAN Health Plan
Missed last week's chart? View Top 5 Medical Home Strategies for Patient Engagement.
Join our Online Communities:
Take this month's e-survey: Improving Medication Adherence in 2013.
Interested in all open surveys? Review them here.
Download new market research: Third Annual Benchmarks in Reducing Readmissions.
Read related blog post: Infographic Real World Strategies for Reducing Readmissions.
Share this data with colleagues on:
Excerpted from Care Coordination for Dual Eligibles: A Results-Oriented Approach, a 45-minute webinar, during which Dr. Timothy Schwab shared his organization's strategic approach to serving the dual eligible market.