Initiatives to Lower Medicaid Costs and Improve Care
- By BSTQ Staff
The U.S. Department of Health and Human Services is launching two initiatives to help states save money and better coordinate care for the nine million Americans enrolled in both Medicare and Medicaid. The first, the Alignment Initiative, is an effort to more effectively integrate benefits under the two programs. Currently, lower-income seniors and people with disabilities must navigate two separate programs: Medicare for coverage of basic acute healthcare services and drugs, and Medicaid for coverage of supplemental benefits such as long-term care support and services, help with Medicare premiums and cost-sharing for those who need additional assistance.
The second initiative is a new process that provides faster state access to Medicare data to support care coordination, a tool that will help states seeking to coordinate care, improve quality and control costs for their highest-cost beneficiaries. For example, a state that wants to expand its long-term care and behavioral healthcare management program to serve low-income seniors and people with disabilities needs data on their Medicare-covered hospital, physician and prescription drug use. With Medicare data, states can identify high-risk and high-cost individuals, determine their primary health risks and provide comprehensive individual client profiles to its care management contractor to tailor interventions. More information on this initiative can be found at www.cms.gov/CMCSBulletins/CMCSB/list.asp#TopOfPage.