For years policymakers and the Centers for Medicare and Medicaid have hypothesized that better integration of healthcare services helps improve outcomes and lower costs.
Now there is evidence to back up the claim, CMS officials said in a blog released Thursday.
In a program in Minnesota, integrated care resulted in fewer hospitalizations and other strong performance-based outcomes, according to a report on the Minnesota Senior Health Options program published by the Department of Health and Human Services.
CMS and the state of Minnesota started the health options pilot in 1997 to better serve dually eligible beneficiaries age 65 and older. The program coordinated all the Medicare and Medicaid benefits the members received, including Medicare coverage of acute medical care and Medicaid coverage of long-term services and supports, CMS said.
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The new report shows the program is effective.
RTI International evaluated outcomes from 2010 to 2012, in a comparison of the experiences of program members and similar beneficiaries.
The report found seniors within the Minnesota program were 48 percent less likely to have a hospital stay, and those who were hospitalized had 26 percent fewer stays; program members were 6 percent less likely to have an outpatient emergency department visit, and those who did visit an emergency department had 38 percent fewer visits. Also, members were 13 percent more likely to receive home and community-based long term care services.
Over the years, the program has become a platform for delivery system reform within Minnesota.
In 2013, CMS made investments to further strengthen the existing program through increased alignment of Medicare and Medicaid program administration, federal-state data sharing, and beneficiary materials.
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CMS is now partnering with 12 other states to implement and evaluate new models of integrated care similar to the one in Minnesota through the Financial Alignment Initiative.
The models are coming at a time when the number of dually eligible beneficiaries served in integrated care programs is rising. From 2011 to 2015, their number rose from approximately 162,000 to more than 650,000, CMS said.
"These new findings from Minnesota affirm the promise of integrated care and reinforce the urgency with which we need to continue to develop, test, and scale successful models for better serving dually eligible individuals," said the blog released by Sean Cavanaugh, CMS deputy administrator and director, Center for Medicare; Tim Engelhardt, director, Medicare-Medicaid Coordination Office; and Vikki Wachino, CMS deputy administrator and director, Center for Medicaid and CHIP Services
Twitter: @SusanJMorse