Reports from Centers for Medicare and Medicaid Services Provide New Insights into Medicare and Medicaid (Dual Eligibles’ Experience of Care with…

Insurance Weekly News

Reports from Centers for Medicare and Medicaid Services Provide New Insights into Medicare and Medicaid (Dual Eligibles' Experience of Care with North Carolina's Patient-Centered Medical Home)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Research findings on Medicare and Medicaid are discussed in a new report. According to news reporting originating in Washington, District of Columbia, by VerticalNews journalists, research stated, "Although individuals enrolled in both Medicare and Medicaid (dual eligibles) are among those with the nation's greatest need, at $300 billion per year, their care is also expensive and beset by quality problems. Previous research found problems associated with inadequate coordination of benefits and services; however, these studies have largely used quantitative approaches and focused on providers-few studies have explored the perspective of dual eligible patients."

The news reporters obtained a quote from the research from Centers for Medicare and Medicaid Services, "In an effort to improve care and reduce costs, North Carolina (NC) developed a Patient-Centered Medical Home (PCMH) model centered on a continuous relationship with a primary care provider who is responsible for coordination of services and addressing patients' health care needs by providing direct services or arranging care with other qualified professionals. This article presents the history of the NC PCMH model and describes results of an in-depth qualitative investigation of dual eligible patients' experience of care with this model. Experience of care was captured through 11 focus groups with 61 dual eligible patients. Focus groups were audio recorded and analyzed using NVivo 9 software, which supported the categorization of data into themes based on frequency and intensity of discussions. Findings indicate that dual eligible patients were generally satisfied by the care received through the NC PCMH program. However, many patients reported continuity of care issues, problems accessing necessary prescription drugs, and difficulties navigating the health care delivery system."

According to the news reporters, the research concluded: "Findings also revealed that conflicting state and federal Medicaid drug co-pay policies confused and limited access for some patients."

For more information on this research see: Dual Eligibles' Experience of Care with North Carolina's Patient-Centered Medical Home. Population Health Management, 2017;20(4):287-293. Population Health Management can be contacted at: Mary Ann Liebert, Inc, 140 Huguenot Street, 3RD Fl, New Rochelle, NY 10801, USA. (Mary Ann Liebert, Inc. - www.liebertpub.com; Population Health Management - www.liebertpub.com/overview/population-health-management-formerly-disease-management/301/)

Our news correspondents report that additional information may be obtained by contacting S. Grantham, Center Medicare & Medicaid Serv, Medicare & Medicaid Coordinat Off, Washington, DC 20201, United States. Additional authors for this research include D.G. Goldberg and D.L. Infeld.

Keywords for this news article include: Washington, District of Columbia, United States, North and Central America, Medicare and Medicaid, Health Policy, Medicaid, Centers for Medicare and Medicaid Services.