More States in the Heartland Look to Coordinated Care to Control Cost of Dual Eligibles

NASHVILLE, Tenn.--(BUSINESS WIRE)--HealthLeaders-InterStudy, the leading provider of managed care market intelligence, finds that states in the Heartland region have programs in the works to coordinate the care of dual eligibles in an attempt to reduce healthcare spending for this costly population. States in the region (Illinois, Iowa, Kansas and Missouri) are developing a variety of Medicare-Medicaid financial alignment demonstrations that will launch in late 2012 and early 2013.

“These programs will focus on adherence to drug prescriptions for chronic conditions.”

Iowa and Missouri plan to use a managed fee-for-service health home model to coordinate care of their dual eligibles. Illinois has received bids from managed care organizations to implement its proposal submitted to the Centers for Medicare & Medicaid Services (CMS).

Kansas officials have indicated they are interested in participating in the CMS program but have not yet submitted a proposal.

“Improving care coordination for dual eligible beneficiaries represents an opportunity for drug companies,” said HealthLeaders-InterStudy Heartland Analyst Joel Peyton. “These programs will focus on adherence to drug prescriptions for chronic conditions.”

Elsewhere in the region an increasing number of employers are becoming more receptive to consumer-driven health plans, narrow networks, defined-contribution arrangements and value-based insurance design.

“This growing interest in health plans that reduce employer costs could make branded drugs unaffordable to patients and restrict access to certain providers who prescribe those drugs,” said Peyton.

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