Defining the Business Case for Targeted Care Coordination

A white paper and series of briefs from Avalere Health produced with support from The SCAN Foundation explore the use of non-medical data to better coordinate care for high risk Medicare beneficiaries, which can lead to improvements in care while providing health plans a return on investment.

Person-Centered Care, Care Coordination

Until the passage of the Affordable Care Act (ACA), Medicare Fee-for-Service (FFS) providers had little incentive to coordinate or manage care for high-cost beneficiaries, much less understand the individual characteristics that likely drive high health care spending. Over the next decade, Medicare Advantage enrollment is expected to grow, Medicare FFS payments will increasingly be tied to value and quality, and providers will inevitably take on more risk to serve an older and likely more complex member population.