New Managed Care Data Have Been Reported by Investigators at University of Pennsylvania (Dual-eligible Nursing Home Residents: Enrollment Growth In Managed Care Plans That Coordinate Care, 2013-20-20): Managed Care

2024 NOV 11 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- New research on Managed Care is the subject of a report. According to news reporting out of Philadelphia, Pennsylvania, by NewsRx editors, research stated, “Dual-eligible beneficiaries have insurance through two distinct and uncoordinated programs: Medicaid, which pays for long-term care; and Medicare, which pays for medical care, including hospital stays. Concern that this system leads to poor quality and inefficient care, particularly for dual-eligible nursing home residents, has led policy makers to test managed care plans that provide incentives for coordinating care across Medicare and Medicaid.”

Funders for this research include Arnold Ventures, Agency for Healthcare Research & Quality, NIH National Institute on Aging (NIA).

Our news journalists obtained a quote from the research from the University of Pennsylvania, “We examined enrollment in three such plans among dual-eligible beneficiaries receiving long-term nursing home care. Two of those plans, Medicare-Medicaid plans and Fully Integrated Dual Eligible Special Needs Plans, are integrated care plans that establish a global budget including Medicare and Medicaid spending. The third, Institutional Special Needs Plans, puts insurers and nursing homes at risk for Medicare spending but not Medicaid spending. Among dual-eligible nursing home residents, enrollment in these plans increased from 6.5 percent of residents per month in 2013 to 16.9 percent in 2020. Enrollment varied across counties but did not vary appreciably with respect to nursing home characteristics, including the share of residents with Medicaid.”

According to the news editors, the research concluded: “As policy makers pursue strategies to coordinate medical and long-term care for dual-eligible beneficiaries, it remains critical to evaluate how these plans influence the care of dual-eligible nursing home residents.”

This research has been peer-reviewed.

For more information on this research see: Dual-eligible Nursing Home Residents: Enrollment Growth In Managed Care Plans That Coordinate Care, 2013-20-20. Health Affairs, 2024;43(9):1296-1305. Health Affairs can be contacted at: Project Hope, 7500 Old Georgetown Rd, Ste 600, Bethesda, MD 20814-6133, USA.

Our news journalists report that additional information may be obtained by contacting Eric T. Roberts, University of Pennsylvania, Philadelphia, PA 19104, United States. Additional authors for this research include Xinwei Chen, Eliza Macneal and Rachel M. Werner.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1377/hlthaff.2023.01579. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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