Bright Spots in Care Management in Medicare Advantage

The Robert Graham Center for Policy Studies recently partnered with BMA to put out a publication, “Bright Spots in Care Management.” You can read the full report here, or download BMA’s one-pager, summarizing the report.

Recommendations for Policymakers

  • Further evaluation and testing of models based on the blueprint presented in this report.
  • Evaluation of differences in outcomes and cost between plans and provider organizations that use care management.
  • Expansion of provider contracts in value-based, risk assumption models that include care management.
  • Incentives for the use of risk stratification to identify high need, high risk patients.
  • Incentives for the use of care management teams that include appropriate personnel, including a registered nurse, social worker and/or a community health worker working closely with clinical staff.
  • Align different payment systems and benefits for dually eligible individuals and patients with multiple chronic conditions through the use of value-based capitated payment.
  • Provide flexibility in payment and coverage to enable providers to treat patients at the most appropriate site of care and to offer additional benefits as needed to meet care goals.
Sign Up for Policy Alerts

Sign up to receive exclusive updates on Medicare Advantage policy.