More than 60 percent of adult Medicaid enrollees have a chronic or disabling condition. Their care, especially for those with multiple chronic conditions, is too often fragmented and unnecessarily costly — consuming as much as 80 percent of state Medicaid budgets. As the debate unfolds over how to best use Medicaid resources, it will be imperative to find ways to get better value for the Medicaid dollars spent on this high-need, high-cost population.
This CHCS report, produced under the Medicaid Value Program: Health Supports for Consumers with Chronic Conditions, was developed to guide states and health plans in designing programs that address the needs of low-income consumers with multiple chronic conditions. A product of extensive research and expert interviews, the environmental scan outlines considerations for caring for consumers with co-morbidities and highlights six key components that are essential for comprehensive, sustainable chronic care:
- Identification of target populations
- Guidelines and measures
- Information technology
- Care management
- Consumer role
- Financing and incentives
While we know a great deal about how to treat specific chronic diseases, there is little information about caring for those with multiple chronic conditions. The Medicaid Value Program: Health Supports for Consumers with Chronic Conditions, undertaken by CHCS with significant backing from Kaiser Permanente and additional support from the Robert Wood Johnson Foundation, will work with 10 innovation teams to develop and test new care delivery models to provide comprehensive care for people with multiple chronic health conditions.