Effective Management of High-Risk Medicare Populations

Sally Rodriguez
Dianne Munevar
Caitlin Delaney
Lele Yang
Anne Tumlinson
September 2014

This resource, drawing on Medicare survey and claims data, a literature review, and interviews, suggests a three-pronged strategy to manage care for Medicare beneficiaries with medical and social needs.

  • The first step is to pinpoint the relevant risk factors, including functional and cognitive impairments.
  • The next step is to improve data collection, such as by adding questions to existing health-risk assessments that go beyond the usual medical and financial questions.
  • Finally, you should implement targeted programs to manage transitions and coordinate care for high-risk members.
  • The study’s analysis of return on investment (ROI) indicates that targeted care coordination programs can yield an ROI of 250 percent.
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