THE IMPACT OF CARE COORDINATION IN MEDICARE-MEDICAID INTEGRATION PROGRAMS

摘要

This paper presents results of a cross-sectional telephone survey of 2,139 adult, dually eligible beneficiaries, including: 744 enrolled in CMC, 659 eligible beneficiaries who opted out, and 736 from non-demonstration counties in California. Results suggest that CMC care coordination is working well: those using care coordination were more likely to be satisfied with benefits and scored higher on measures of access to care than non-users. Of those who experienced disruptions in care after the transition, care coordination users were more likely to report those disruptions resolved than non-users. However, the only characteristic that predicted use of care coordination was use of behavioral health. Those in poor health and those with functional limitations, both characteristics that predict more disruptions in care, were not more likely to receive care coordination. Presenter will discuss the importance of risk stratification to ensure that it is being administered to those with the most complex care needs.