This Week's Challenge: Care coordination of the 9 million Americans eligible for both Medicare and Medicaid is a growing priority for the nation’s payors who wish to address this group’s unique medical, social and functional needs in a coordinated and cost-efficient manner. We wanted to see which healthcare professionals are responsible for the care coordination of dual eligibles.

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What We Learned: HIN's industry survey on care coordination of dual eligibles captured how 72 healthcare organizations coordinate the care of dual eligibles, including how duals are stratified into a care coordination program, the key characteristics of the duals population served, the greatest administrative challenge of coordinating care for duals, and much more. According to survey respondents, the top five professionals responsible for dual eligible care coordination are:

• Case manager: 37.5 percent
  
  
• PCP: 25 percent
  
  
• Other: 12.5 percent
  
  
• Social worker: 12.5 percent
  
  
• Pharmacist: 6.3 percent

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HINfographic: Defining the Dually Eligible — 16 Things to Know for Population Health Management.

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Excerpted from 2013 Healthcare Benchmarks: Dual Eligibles Care Coordination, which examines emerging trends in duals care management, from the prevalence of existing programs to gains achieved in key quality metrics like patient satisfaction.

© 2013 Healthcare Performance Benchmarks by Healthcare Intelligence Network.
Editor: Jessica Fornarotto, [email protected];
Publisher: Melanie Matthews, [email protected]