Managing Vulnerable Populations

Designing Comprehensive Support for Medicaid and Dual-Eligible Beneficiaries

Explore strategies for improving care management for three distinct Medicaid patient populations:

  • Health Care Advisory Board members, log in to download the research briefing.

Executive Summary

You’re about to get a lot more patients on Medicaid, and the best way to support them is through comprehensive care management models.

For every 1% increase in unemployment, a million more people enroll in Medicaid and CHIP.Perfecting care management helps everyone. Your patients benefit, your bottom line improves, and you’ll be more prepared for the coming wave of Baby Boomers entering Medicare.

Since improving outcomes requires a combination of patient activation and health care delivery system redesign, providers are uniquely positioned to drive quality and cost improvements for these vulnerable patients.

This isn’t about finding new resources to manage care—it’s about using existing resources around the medical perimeter more efficiently.

This can be a daunting task. Though half of Medicaid enrollees are children, the majority of the program’s health care spending is for adults and complex elderly patients.

The most effective plan is to start with the populations with the highest costs and the most unmet care needs. Ultimately, you will want to:

  • Promote an evidence-based approach to maternity care
  • Partner to develop chronic care resources
  • Design a proactive approach for dual-eligibles

Caring for each population builds on a few common themes—direction to the right site of care, collaboration within (and beyond) the care team, and incorporating community resources.

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Health Care Advisory Board members, log in to download the research briefing. Not a member? Visit the Health Care Advisory Board's website or contact us to learn more.