Transforming Care for Medicare Beneficiaries with Chronic Conditions and Long-Term Care Needs: Coordinating Care Across All Services


This policy brief is the first of two publications from Georgetown University on transforming models of care. The paper affirms that in order to improve care delivery and manage costs, innovations for Medicare beneficiaries who have both chronic conditions and functional impairments should be a top priority.

Date Updated: 10/12/2011

I. Introduction

People with chronic conditions are at center stage in efforts to transform health care delivery from encouraging more—and more-costly—services to promoting prevention, primary care, and care coordination. Fragmentation and lack of coordination in health care services are increasingly regarded as not only a source of frustration for patients, but also as both impediments to quality care and drivers of health care costs. The Affordable Care Act accordingly charges Medicare with payment and delivery reforms to improve care and slow cost growth not only for its beneficiaries, but to jumpstart and influence system-wide change…

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