OBSERVATIONS - October 24, 2007
Improving Care in Medicaid: IHP Roundtable Advances the Dialogue
The Medicaid program provides health and long-term care services
to 55 million low-income people, including families, people with
disabilities, and the elderly, representing just under $315 billion
of spending in 2006. Although women and children account for the
majority of Medicaid enrollment, the bulk of the program’s
spending is for beneficiaries with multiple chronic conditions.
Focusing on these individuals offers the best opportunities to improve
quality of care and reduce costs for the program.
What changes are needed to best serve high-need, high-cost individuals?
This question motivated Kaiser Permanente’s
Institute for Health Policy, Kaiser
Permanente Community Benefit, and the Center
for Health Care Strategies (CHCS) to sponsor an invitational
roundtable meeting, “Improving Care for Medicaid Consumers
with Multiple Chronic Conditions: Opportunities and Policy Issues.”
This meeting, held October 4 in Washington, DC, brought together
leaders from state and federal government, policy analysis organizations,
health care delivery, and academia to stimulate policy and research
strategies to support system-wide improvements in care.
This session built upon the findings of two CHCS initiatives supported
by Kaiser Permanente Community Benefit and the Robert
Wood Johnson Foundation: - Medicaid Value Program (MVP), a 10-site
collaborative testing innovative models of care for Medicaid beneficiaries
with multiple chronic conditions, and The
Faces of Medicaid II: Recognizing the Care Needs of People with
Multiple Chronic Conditions, an exploration of the prevalence
and patterns of chronic conditions among Medicaid beneficiaries.
The CHCS initiatives make clear both the limitations of “siloed”
disease management approaches for treating people with multiple
chronic conditions, and the challenges of developing more holistic
approaches to care for people with both medical and psychosocial
or mental health needs. These gaps present opportunities to those
that care for and develop policy around Medicaid beneficiaries to
support care delivery that is more person-centered than disease-centered,
and that addresses the clinical or psychosocial issues that most
affect the patient’s well-being.
The roundtable built upon these ideas with discussion of what could
help or hinder the development and dissemination of best practice
models. Participants concurred on the importance of a focused research
agenda, but more importantly on the need for sharing research results
and best practices and on transferring knowledge into practice.
A more formal summary of this meeting will be available on this
website in November and will describe the most important themes
and implications for action identified by the participants.
-- Kate Meyers, MPP, Senior Policy Consultant,
and Murray Ross, PhD, Director of Health Policy Analysis and Research,
KP IHP
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