Shared savings may promote care coordination entity use

January 7, 2013
Shared savings may promote care coordination entity use
Use of shared savings could encourage individuals who are dually eligible for Medicare and Medicaid to enroll in state-designed care coordination entities, according to a perspective piece published online Jan. 2 in the New England Journal of Medicine.

(HealthDay)—Use of shared savings could encourage individuals who are dually eligible for Medicare and Medicaid to enroll in state-designed care coordination entities (CCEs), according to a perspective piece published online Jan. 2 in the New England Journal of Medicine.

Richard G. Frank, Ph.D., from Harvard Medical School in Boston, discusses the issues surrounding new federal policy initiatives that promote integration and of care for dually eligible individuals. Noting that the population is more likely to have multiple , a severe , or , and that financing of support for this population often results in high-cost, low-quality care, policymakers believe that greater coordination of care will result in savings and improved care.

According to the report, nearly all states are establishing passive-enrollment methods to foster the transition to more structured coordinated-care arrangements. The use of passive enrollment would likely produce higher rates of enrollment into CCEs, but the benefits may be less clear to beneficiaries. To promote self-determination and offer individuals a reason to engage with coordinated care, patients could be included in shared savings, whereby a share of the savings is set aside into an account to be used toward supplemental services and supports. Shared savings could also be coupled with encouraging beneficiaries to choose among options rather than defaulting into a CCE or status quo, which may result in greater enrollment than an opt-in system.

"It is important to advance program designs that have the potential to improve care and save money, but we need to do so in a way that promotes self-determination and the exercise of real options," Frank writes.

Explore further: Reformed Medicaid program must put coordinated care at forefront of efforts

More information: Full Text

Related Stories

Recommended for you

Rio athletes may benefit from 'leaky gut' therapy

June 29, 2016

'Leaky gut' is a condition where the thin mucosal barrier of the gut, which plays a role in absorbing nutrients and preventing large molecules and germs from the gut entering the blood stream, becomes less effective.

Doctors swamped by 'e-medicine' demands

June 29, 2016

(HealthDay)—Doctors say they're drowning in electronic paperwork, feeling burned out and dissatisfied with their jobs thanks to countless hours spent filling out computerized medical forms, researchers report.

E-cigarette vapors could be toxic to mouth, study finds

June 28, 2016

A new UCLA study suggests that e-cigarettes may not be significantly safer than tobacco cigarettes. The research, which was conducted on cultured cells, found that e-cigarettes contain toxic substances and nanoparticles that ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.