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Medicare-Medicaid Coordination Alignment Recommendations

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Medicare-Medicaid Coordination Alignment Recommendations

May/June 2015

From the Remington Report Magazine issue: The Game Changer: Transformation From Volume To Value

A new report to Congress from the Medicare-Medicaid Coordination Office (MMCO) notes its work to drive alignment of needs and care of dually eligible recipients of Medicare and Medicaid government resources. This population is sizeable: it numbers 10.7 million Americans as of 2014. As noted in its report to Congress, the MMCO compiled an Opportunities for Alignment List from which it developed two models to improve care and reduce costs for Medicare/Medicaid enrollees. These models are: The Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents [in this case, partnering with the Centers for Medicare & Medicaid Services (CMS) and other organizations to reduce avoidable and costly hospitalizations by Medicare/Medicaid enrollees who are long-term residents of nursing facilities]; and The Financial Alignment Initiative [in which the MMCO, in partnership with the CMS Innovation Center, is working so far with 350,000 Medicare/Medicaid beneficiaries who are participating in a demonstration study underway in 8 states which seeks to improve care, coordination, and access of these enrollees]. The MMCO’s actual report to Congress offers recommendations which mainly focus on means for improving the coordination of care for dually eligible individuals. A bulleted list of these recommendations appear near the end of this article.

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