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来源类型 | Report |
规范类型 | 报告 |
DOI | https://doi.org/10.7249/RR2634 |
来源ID | RR-2634-ASPEC |
Addressing Social Determinants of Health Needs of Dually Enrolled Beneficiaries in Medicare Advantage Plans: Findings from Interviews and Case Studies | |
Melony E. Sorbero; Ashley M. Kranz; Kathryn E. Bouskill; Rachel Ross; Alina I. Palimaru; Amanda Meyer | |
发表日期 | 2019-04-12 |
出版年 | 2018 |
页码 | 86 |
语种 | 英语 |
结论 |
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摘要 | Dually enrolled beneficiaries in Medicare and Medicaid are less likely to be enrolled in Medicare Advantage (MA) plans that perform well in the MA Star Rating program than non–dually enrolled beneficiaries. Some plans with a high proportion of dually enrolled beneficiaries, however, perform well in the MA Star Rating program. Through interviews with stakeholders and case studies of high-performing Medicare-Medicaid Plans (MMPs) and MA plans, the authors identify ways MA plans and plans participating in the MMP demonstration are working to meet the needs of their dually enrolled beneficiaries. The plans with high ratings in the MA Star Rating program reviewed in this study reported implementing multipronged approaches to address the needs of their complex member populations, including health-risk assessments, care management and coordination, referral or direct services, and better integrating Medicare and Medicaid. Reported outcomes associated with these plan strategies and interventions highlighted in case studies included reductions in emergency department visits and hospitalizations and other unplanned utilization. ,To support organizations with MA contracts in their efforts to meet the needs of dually enrolled and other high-need beneficiaries, policymakers and other stakeholders can (1) use patient-centered performance measures relevant to the needs of dually enrolled beneficiaries; (2) account for clinical complexity and social risk in performance measures; (3) align care interventions and incentives in value-based purchasing programs, such as the MA Star Ratings; and (4) build a supportive environment through policy and by strengthening community resources. |
目录 |
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主题 | Health Care Access ; Health Care Costs ; Health Care Organization and Administration ; Health Care Quality ; Medicaid ; Medicare ; Social Determinants of Health |
URL | https://www.rand.org/pubs/research_reports/RR2634.html |
来源智库 | RAND Corporation (United States) |
引用统计 | |
资源类型 | 智库出版物 |
条目标识符 | http://119.78.100.153/handle/2XGU8XDN/523779 |
推荐引用方式 GB/T 7714 | Melony E. Sorbero,Ashley M. Kranz,Kathryn E. Bouskill,et al. Addressing Social Determinants of Health Needs of Dually Enrolled Beneficiaries in Medicare Advantage Plans: Findings from Interviews and Case Studies. 2019. |
条目包含的文件 | ||||||
文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
RAND_RR2634.pdf(929KB) | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
1555073368059.jpg(4KB) | 智库出版物 | 限制开放 | CC BY-NC-SA | ![]() 浏览 |
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