Dual Eligible Demonstrations (U.S. Medicare/Medicaid): Resources for Advocates - The Commonwealth Fund

Dual Eligible Demonstrations: Resources for Advocates - The Commonwealth Fund

Overview

In April 2011, the Centers for Medicare and Medicaid Services (CMS) awarded $1 million grants to 15 states for the design of integrated service delivery and payment models for dual eligibles, people with high health care needs who are enrolled in both Medicare and Medicaid. CMS has emphasized that consumer stakeholders must be included in the planning processes. A new Commonwealth Fund–supported Web site, http://dualsdemoadvocacy.org/, offers educational resources for consumer groups and can serve as a platform for sharing ideas and strategies for improving care for dual eligibles.

The Problem

States are struggling to find ways to engage consumers in the development of integrated models of care for people with Medicare and Medicaid. At the same time, consumer representatives say they need resources to help them gain a better grasp of the technical design and implementation issues involved.

Audience

Health care consumers and state consumer advocates

The Intervention

The Web site http://dualsdemoadvocacy.org/ is a resource for consumers and advocates that provides background information, links to news and events, and, in the Advocate Tools section, concrete recommendations to help advocates work with state policymakers to ensure that new delivery models improve care for dual eligibles. The Advocate Tools cover such topics as the development of the appeals process if health plans or providers deny needed care; patient assessment and care planning; consumer protections; and provider payment models. The site also offers state-by-state information about the dual eligibles population and the demonstration projects that local policymakers are considering. The site also features a custom search tool to direct users to the most valuable resources on the Web about dual eligibles..

For More Information

Visit http://dualsdemoadvocacy.org/.

abstract: Treating cervical cancer: Breast and Cervical Cancer Prevention and Treatment Act patients - access to care

Note: not ovarian cancer related but access to care issues

Conclusion

Treatment patterns among Georgia Medicaid cases appear appropriate to stage but 18% with invasive cervical cancer received no cancer treatment, although Medicaid enrolled.

Donald Berwick takes charge of Medicare and Medicaid : The Lancet

Berwick's Institute for Healthcare Improvement (IHI) developed programmes in the US and around the world that focused on improved delivery systems. Among the group's innovations is the “100 000 Lives” campaign, which challenged hospitals to reduce medical errors. Altman said the programme “almost single handedly” changed attitudes among hospital administrators towards a focus on patient safety.

Obama Chooses Health Policy Scholar as the Director for Medicare and Medicaid - NYTimes.com

Note: I have met Dr Berwick (via WHO Patient Safety), an extraordinarily compassionate individual

"WASHINGTON — President Obama will soon name Dr. Donald M. Berwick, an iconoclastic scholar of health policy, to run Medicare and Medicaid, the programs that serve nearly one-third of all Americans, administration officials said Saturday.

Dr. Berwick, a pediatrician, is president of the Institute for Healthcare Improvement in Cambridge, Mass. He has repeatedly challenged doctors and hospitals to provide better care at a lower cost...."

"Dr. Berwick has denounced “the insanity of health care that costs too much and achieves too little.” But at the same time, he celebrates the work of hospitals that have reduced medical errors and deaths by the systematic application of proven techniques. And he wants to disseminate the secrets of communities that provide high-quality care at low cost."