Start: December 2013

Funder: The Commonwealth Fund

As states across the country advance new integrated programs for the approximately 10 million individuals who are dually eligible for Medicare and Medicaid (also known as Medicare-Medicaid enrollees), health plans are seeking strategies to better serve this high-need, high-cost population.

PRIDE_LogoThrough PRomoting Integrated Care for Dual Eligibles (PRIDE), made possible by The Commonwealth Fund, CHCS is helping health plans to further the viability and increase the impact of integrated care models for Medicare-Medicaid enrollees. PRIDE is currently working with leading health plans to explore strategies for advancing integrated care models, including: value-based purchasing; tele-health; and operations management issues, such as risk stratification, care management, and assessment and care planning. Participating plans include: BlueCare Tennessee (Tennessee); CareSource (Ohio); Commonwealth Care Alliance (Massachusetts); Health Plan of San Mateo (California); Independent Care Health Plan (iCare) (Wisconsin); Inland Empire Health Plan (California); UCare (Minnesota); and VNSNY CHOICE Health Plans (New York).

Through PRIDE, these plans are: (1) sharing their key challenges and success factors; (2) implementing best practices for achieving high performance; and (3) informing the dissemination of successful strategies to effectively serve individuals dually eligible for Medicare and Medicaid. CHCS is supporting participating health plans with opportunities for collaborative learning and direct technical assistance. Lessons from PRIDE are shared nationally.

Previous efforts under PRIDE focused on strategies for finding hard-to-reach members, engaging providers, and enhancing care management systems. Explore resources and tools at the links below.