Integrated care for dual eligible population

Formerly, we have discussed accountable care organization and pointed to that ACO is a delivery model of integration comes closely with medical providers and other stakeholders.  In this post we are going to take deeply other corner somehow touch indirect benefits of medical system integrations. Dual eligible is category of society (people) eligible to Medicare & Medicaid and they are nearly 9 million in US. Majority of this category are low income retired seniors above 65 years and may be older, 3.4 million from 1^st number younger with disabilities according to NCHS (the national center for health statistics). Dual eligible mostly lower than ten thousands USD and that cost the system additional costs particularly for them to overcome their urgently needs of medical services that widely differ from normal medical services routine.

This example of additional services needed for certain category of community is reflect the probing characters of integrations; probing mean you exactly know where and how to put additional services and positioning your costs and additional demands according to special community request. many think integration of medical system may running the same parameters overall and with the standards. Indeed that may be going with normal routine medical daily services but with certain categories as previous example we could not accomplish the same neglecting additional services in some cases. In order to continue the solution of dual eligible category as an evidence of modification of integrating system.

US government put special needs plans SNPs that serve their additional medical demands as follow:

Ø  Chronic Condition SNPs (C-SNPs)

Ø  Dual-Eligible SNPs (D-SNPs)

Ø  Institutional SNPs (I-SNPs)

Every plan program have some requirement for each category according to patient and diseases and that specify patient needs and determine the budget for each plans. Delivery of these services do not carry differences than other normal in state or government providing medical care but with clearly modification matching the different diseases and people special needs may normal received values would not give the best results.

medical system integration is acting properly in numerous country and control medical service provision in level surprised many but still from personal viewpoint considered the best to link, monitoring, management the medical system delivery channels on the state level. In coming posts; we are going to show other sides and forms of integrations and if there some barriers prevent integration medical system from maximizing the acclimatization with recent people and societies medical needs or not?, keep followJ