As Community Catalyst points out in its Health Policy Hub blog on this topic, promoting new models of care is an important tool in reducing costs because:
The dual eligible populations (approximately 9 million) are a lot more vulnerable and typically have poorer health status and a greater need for more high-cost services such as inpatient and outpatient hospital, emergency room, and skilled nursing care. Navigating the Medicare and Medicaid programs, which have different sets of rules and requirements, is an added burden for beneficiaries and results in care that is often fragmented and uncoordinated.The Innovation Center recently released guidance for certain pilot projects to test new models of care that allow states who improve quality with better integration for duals to reap the benefits of the lower costs.
We are always monitoring federal initiatives but lately we've been focusing our time and energy on protecting MaineCare in the state budget. Rather than pursuing proposals that target the costliest programs and better integrate care, the Governor and Legislature have supported across-the-board cuts that eliminate coverage for some low-income parents and all non-categorical individuals (childless adults) that have depended on this care for nearly a decade.
The bottom line is that no matter how enticing cost reduction in these programs may be, ensuring that patient needs are met is the top priority. Both advocates and policymakers share the goal of cutting health care costs but clearly disagree on the means to achive those savings. The Maine Campaign for Better Care and its national partners support alternatives to cuts in the MaineCare program that improve care quality rather than cut populations or important services. We believe states can have their cake and eat it too.