Care Coordination

This case study examines the benefits of coordinating care for dually eligible members with serious mental illness. It looks specifically at how one Pennsylvania plan used a robust care coordination and member engagement model to successfully reduce urgent and unplanned inpatient admissions; and optimize health outcomes, quality of life, and self-management skills for individuals with serious mental illness.

The Patient Centered Medical Home Network of The John A. Hartford Foundation Change AGEnts Initiative released a new paper titled, "Patient-Centered Medical Homes and the Care of Older Adults: How comprehensive care coordination, community connections, and person-directed care can make a difference.”

The Centers for Medicare & Medicaid Services (CMS) began the Financial Alignment Demonstration in 2013 to improve care coordination. GAO was asked to examine care coordination under this demonstration. On January 19, The Government Accountability Office publicly released a report with their recommendations for CMS. GAO recommends that CMS develop new measures and align the current measures to improve oversight of care coordination.