1) Over 8 million "duals" (people eligible for both Medicare and Medicaid) account for about half of all Medicaid spending, with a small portion accounting for over 70% of dual spending.
2) Integrating Medicare and Medicaid benefits can improve care coordination and outcomes for duals while reducing costs by eliminating duplication and gaps in care.
3) Several models of integration exist including Special Needs Plans, PACE programs, shared savings models, and making the state the entity responsible for integrating benefits, each with their own advantages and disadvantages.
Health Information Technology, Quality Improvement, and the Delivery System R...NASHP HealthPolicy
Maryland has established a "phalanx" strategy to coordinate implementation of health IT, quality improvement initiatives, and delivery system reforms. The phalanx involves a large number of stakeholders working together, with leadership serving on the front line to push initiatives forward. While linking payment to quality and changing hospital payments will face challenges, having many groups collaborating and supporting each other can help drive changes through. The state has made progress in areas like establishing a health information exchange, adopting electronic health records, and developing medical home pilots. Fully achieving reforms will require maintaining stakeholder cooperation and momentum.
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