Some 9 million Americans are eligible for both Medicare and Medicaid. These patients tend to be older, have lower incomes, and have more health problems than individuals who qualify for just one of the federal programs. Although care for “dually eligible” patients is costly, complex, and often fragmented and poorly coordinated, great potential exists for new models of care delivery—including a robust integration of clinical and social services—that will bring better health outcomes and greater consumer satisfaction, while also possibly lowering costs and reaping savings that could be reinvested in prevention and early detection.
To advance research into high-performing health care delivery models, the Peterson Center on Healthcare recently announced a grant of nearly $3 million to three institutions, including the Harvard T.H. Chan School of Public Health, that will collaborate to identify and validate health care solutions to lower costs and improve quality of care for these high-risk patients. The Harvard Chan School received $686,000 to analyze three years of medical claims data of dually eligible patients with similar health profiles. The aim is to identify differences in how care is provided, calculate how those differences may lead to variations in outcomes and costs, and determine how much of that variation is preventable. According to principal investigator Ashish Jha, MD ’97, MPH ’04, director 0f the Harvard Global Health Institute and K.T. Li Professor of International Health at the Harvard Chan School, “If we can understand the patterns of care that allow some patients to achieve better outcomes than others or receive more efficient care, then we can move much closer to identifying the models of care that improve quality and lower costs.”
The two other beneficiaries of the grant are the National Academy of Medicine and the Bipartisan Policy Center. “Each [of the three institutions] brings a depth of expertise and know-how that will ultimately benefit people who really need better care and the health system as a whole,” says Jeffrey Selberg, executive director of the Peterson Center on Healthcare.
— Jan Reiss is assistant director of development communications and marketing.