Research & Policy Library

States looking to better coordinate care and manage cost are seriously considering the managed care model as an option to provide Medicaid services to people with complex health care needs.  The Kaiser Commission on Medicaid and the Uninsured issue brief, "Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care:  Insights from California,"  examines how providers, health plans, and community-based organizations in three counties (Contra Costa, Kern, and Los Angeles) experienced the California’s transition of approximately 240,000 seniors and people with disabilities to Medicaid managed care.  This brief reinforces the need for adequate time, communication, planning, and partnerships in order to ensure continuity of care.

Attention has been given to dual eligibles (people who use both Medicaid and Medicare) due to the rising cost of care and fragmented service system.  In the report, "Dual-Eligible Beneficiaries of Medicare and Medicaid:  Characteristics, Health Care Spending, and Evolving Policies," CBO takes a closer look at data describing duals, spending trends, and efforts to better coordinate services and reduce cost.

Recognizing the significant role family caregivers play in successful transitions of people with chronic conditions from acute care to community care, the United Hospital Fund published Transitions in Care 2.0 – An Action Agenda laying out a plan for health care providers, regulators, payers, etc. to better incorporate caregivers and their needs in transition planning.

An April 2013 report from the AARP Public Policy Institute from its Insight on the Issues series titled, "Two-Thirds of States Integrating Medicare and Medicaid Services for Dual Eligibles,"  finds that two-thirds of the states either have or will launch new initiatives to better coordinate care for people who are dually eligible for Medicare and Medicaid services, the so-called "duals," over the next two years.  To contain the growth of costs and improve care, many of them are moving to risk-based managed long-term services and supports models.