This reference guide summarizes a set of curated resources to help key stakeholders better understand both the needs of the dually eligible population and emerging evidence and practical approaches for advancing Medicare-Medicaid integration.
Highlights experiences from the Center to Advance Palliative Care’s Medicare Advantage and ACO Learning Communities with strategies for improving serious illness care, as well as resources that health plans and ACOs can use to drive better value and improve the quality of life for those living with serious illness.
Describes how two health plans — Anthem, Inc. and Highmark Blue Cross Blue Shield —organizations introduced a palliative care measure into their hospital value-based payment programs, which has led to significant improvements in access to palliative care for their seriously ill members.
Highlights how skilled nursing facilities are switching to the Patient Driven Payment Model — a payment system that removes therapy minutes as the basis for payment and enhances payment accuracy for services by making reimbursement dependent on a wide range of clinical characteristics.
For frail older adults with complex care needs, an inpatient hospital stay is destabilizing and often marks the beginning of a decline in functioning. For these older adults and their families, the post-hospital period is a risky, confusing, and stressful time.