A Primer on Managed Care: Multiple Chronic Conditions
assistance, home modifications, and many other types of assistance. The challenge continues to be how to expand the flexibility of healthcare dollars to cover the costs of community services. A community inter- vention often costs a fraction of a medical inter- vention. Health and social service sectors will need to continue to show that these interventions result in the same or better outcomes at a lower cost. Meeting the person where they are, under-
standing what they define as their greatest need, and responding to that need sounds easy concep- tually but, in practice, the current system is not designed to support this approach to care. Erin Westphal is a program officer for The SCAN Foundation in Long Beach, California. Her work focuses on building the business case for person- centered care models and integrating the care and financing for medical and social services.
References Better Medicare Alliance. 2017. “Understanding Risk Adjustment in Medicare Advantage.” tinyurl. com/ya3k92xf. Retrieved October 22, 2018. Centers for Medicare & Medicaid Services (CMS), and Medicare Learning Network. 2017. “Hospital Value-based Purchasing.” tinyurl. com/lfed3dt. Retrieved October 22, 2018. CMS. 2018a. “Financial Alignment Initiative.” tinyurl.com/pn3wfcw. Retrieved October 22, 2018. CMS. 2018b. “Accountable Care Organizations.” tinyurl.com/ pn3wfcw. Retrieved October 22, 2018. CMS. 2018c. “NOTE TO: Medicare Advantage Organizations, Pre- scription Drug Plan Sponsors, and Other Interested Parties.” tinyurl. com/ycak6kl2. Retrieved October 22, 2018.
Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017. 2017. S. 870. 115th Cong. tinyurl.com/y9ej4lqu. Retrieved October 22, 2018. Figueroa, J. F., et al. 2017. “Concen- tration of Potentially Preventable Spending Among High-cost Medi- care Subpopulations: An Obser- vational Study.” Annals of Internal Medicine 167(10): 706–13. Joynt, K. E., et al. 2017. “Segment- ing High-cost Medicare Patients into Potentially Actionable Co horts.” Healthcare 5(1–2): 62–7. Office of Disease Prevention and Health Promotion. 2018. “Social Determinants of Health.” tinyurl. com/z32yfnv. Retrieved October 22, 2018.
Rudowitz, R., and Garfield, R. 2018. “10 Things to Know About Med- icaid: Setting the Facts Straight.” Henry J. Kaiser Family Foun- dation. tinyurl.com/y9toy8um. Retrieved October 22, 2018. The SCAN Foundation. 2018. “Ten Questions to Better Understand and Serve Your Complex Care Pop- ulation.” tinyurl.com/yayjy5xn. Retrieved October 22, 2018. Tumlinson, A., and Johnson, M. 2018. “CHRONIC Care Act: Mak- ing the Case for LTSS in Medicare Advantage Supplemental Benefits.” The SCAN Foundation. tinyurl. com/ybrx6wtz. Retrieved October 22, 2018. Wullianallur, R., and Raghupathi, V. 2018. “An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach to Public Health.” International Journal of Environmental Research and Public Health 15(3): 431.
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