Perspectives: Keeping Health Care Costs from Going Awry: Care Coordination is a Key

Sadly for most vulnerable older Californians, their first interaction with long-term services and supports (LTSS) begins in the emergency room. A recent report from California’s Medicaid Research Institute (CAMRI) shows that this perspective is particularly true for individuals covered by Medicare and Medi-Cal. Most people who used Medi-Cal-funded LTSS started these services after an emergency room visit, hospital admission, or rehabilitation stay. Older adults entering these institutions may experience additional health complications, be discharged with less function than when they entered, and find their support system at home less prepared to meet their needs. 

Dual Eligibles, Care Coordination

In 2009, The SCAN Foundation in partnership with the state Department of Health Care Services brought together all sources of payment data for Californians eligible for both Medicare and Medi-Cal. The goals were to understand the needs and service use of this population better to know what works and what doesn’t in care delivery. This new report gives a much clearer understanding of the system inefficiencies and more importantly, missed care delivery opportunities. The findings point toward opportunities to use the state’s limited resources in different ways that might better support this population’s health and daily living needs.