Coordinated care pushed

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Authors of a new report recommend creating an integrated care model for dual-eligible Medicare and Medicaid beneficiaries. The result would be better coordinated care, and at a lower cost, they say.

The plan called for by the Association for Community Affiliated Plans (ACAP) is somewhat similar to Programs of All-Inclusive Care for the Elderly (PACE), which now has 23,000 nursing home-eligible seniors enrolled.

Called the Very Integrated Program (VIP), it would be a permanent integrated, capitated care model states could use as their Medicaid plan. They would save by treating more beneficiaries at home, lower costs for hospitalizations or nursing home admissions.

It is now being tested in pilot programs in limited locations.

Ideally, beneficiaries would have to opt out, rather than in, to create a big enough participant pool.

The 9 million people who qualify for Medicare and Medicaid accounted for around $230 billion in federal and state spending in 2006, according to ACAP report authors from George Washington University.

“States are uniquely experienced in the provision of long-term care services and supports, as well as behavioral health benefits and services, which often are more robust under Medicaid than Medicare,” they wrote.