One Care – Health Stew

I am reprinting an article I wrote for the new issue of Commonwealth Magazine concerning One Care, Massachusetts’ bold and risky experiment to coordinate care for the so-called “dual eligibles” who are under age 65 and disabled. It has been a tough ride in the program’s first two years. In this piece, I give the background and context for One Care and propose that we stay the course as the smart and right thing to do:

BACK IN 2008, when I was working in the US Senate on national health reform, a delegation of 20 business leaders from the New England Council visited Capitol Hill to offer advice. The group’s leader was Charlie Baker, then Harvard Pilgrim Health Care’s CEO. I recall his one recommendation: “You have to do something about dual eligibles because they are one of the most important and expensive pieces of the puzzle.”

As Massachusetts now struggles to sustain One Care, its nationally significant dual-eligibles demonstration project that launched in October 2013, Gov. Baker’s hope is happening. Given the project’s rocky and difficult first 18 months, he could be forgiven for wondering if he could rewrite that wish. Continue reading “No Time to Go Wobbly on “One Care””

A new report from the Kaiser Family Foundation puts a welcome spotlight on a most important U.S. health reform demonstration — called One Care — going on first and right now in Massachusetts. How wonky is this? The report title says it all: Early Insights from One Care: Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries. What’s it all about?

A population of Americans known as the “dual eligibles” is among the nation’s most needy and expensive groups. They are 9.6 million elderly and disabled low-income Americans who are dually enrolled in both Medicare and Medicaid. For most of the 50 year history of the two programs, the “duals” fell between the cracks, getting poorly coordinated or no care. Twelve years ago, with federal support, Massachusetts’ Medicaid program, called MassHealth, started a “Senior Care Options” (SCO) program for coordinated/managed care for duals over age 65. Continue reading “A Most Important Demo You’ve Never Heard of… “One Care””