The high and rising cost of health care is a central concern for governments at all levels, employers and families. A large portion of the cost problem can be traced to the care received by persons with chronic conditions like asthma or diabetes. Treating those with multiple chronic conditions, including the elderly and disabled populations, accounts for 30 percent of total U.S. health care spending as of 2010. Half of this amount is spent by Medicare and Medicaid on behalf of beneficiaries eligible for both programs.
It may be possible to improve the quality of care for the chronically ill while altering the trajectory of spending for their care. Savings have been shown in some private and public sector approaches using teams that span multiple sites of care, reduce fragmentation and improve health outcomes. In addition, the Patient Protection and Affordable Care Act establishes new pilots and innovations that could change the way we deliver care to the chronically ill and the way we pay for it.
How can Medicare, Medicaid, private plans and providers partner to develop new approaches and achieve public health goals? Could these programs address the different needs of populations in institutional care versus community-based care? How do these new models differ from former approaches? What infrastructure and training enhancements are needed? What have we learned from states that have tried Medicaid case management for the chronically ill?
To address these and related questions, the Alliance for Health Reform and The Commonwealth Fund sponsored an August 11 briefing. Panelists were: Lois Simon, Commonwealth Care of Massachusetts; Pam Parker, Minnesota Senior Health Options; and Randy Brown, Mathematica Health Policy Research. Cathy Schoen of Commonwealth and Ed Howard of the Alliance co-moderated.
Full Transcript (Adobe Acrobat PDF)