UNDERSTANDING CARE COORDINATION EXPERIENCES IN A STATE MEDICAREMEDICAID FINANCIAL ALIGNMENT DEMONSTRATION

Known as dual eligible beneficiaries, individuals receiving Medicare and Medicaid benefits often have complex needs and account for a disproportionate share of healthcare spending. In 2014, Virginia implemented Commonwealth Coordinated Care, a managed care financial alignment demonstration authorize...

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Bibliographic Details
Published inJournal of health and human services administration Vol. 41; no. 2; pp. 196 - 236
Main Authors Craver, Gerald A, Gimm, Gilbert, Hill, Katherine E Vatalaro
Format Journal Article
LanguageEnglish
Published Harrisburg Southern Public Administration Education Foundation 01.10.2018
Subjects
Beneficiaries
Capitation
Continuity of care
Coordination
Cost shifting
Data analysis
Data collection
Disability
Enrollments
Health care
Health care expenditures
Health care policy
Health risk assessment
Health risks
Initiatives
Interdisciplinary aspects
Medicaid
Medicare
Patient Protection & Affordable Care Act 2010-US
Public finance
Qualitative research
Washington DC
United States > US
Virginia
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Summary:Known as dual eligible beneficiaries, individuals receiving Medicare and Medicaid benefits often have complex needs and account for a disproportionate share of healthcare spending. In 2014, Virginia implemented Commonwealth Coordinated Care, a managed care financial alignment demonstration authorized under the Affordable Care Act, to improve care for these individuals. Given the complexity of their needs, examining how dual eligible beneficiaries along with their care coordinators and providers experienced the demonstration is important. By analyzing qualitative data collected as part of a larger mixed-methods evaluation, several themes were identified illustrating individuals' experiences. The study findings suggest that how individuals interacted and formed relationships influenced how beneficiaries' health and social needs were met during the program. By providing insight into individuals' experiences in a managed care program that integrated medical and long term services and supports for Medicare-Medicaid beneficiaries, the study can inform the development of future initiatives for similar populations.
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ISSN:1079-3739
2168-5509