Studies and Research on Care Coordination and Reducing Uncoordinated Care

Example of Recent Medicaid Projects

Comprehensive claims analyses have been performed for a number of state Medicaid programs, which included utilization and expenditure analyses of drugs and medical services, a disease profile of the population, and the identification of access patterns indicative of uncoordinated care in a small subset of the population. We examined drug and medical utilization and costs attributed to these uncoordinated care patients and conducted statistical-based, predictive modeling to estimate future target costs and estimated program savings following a multiple intervention approach to better coordinate care.

The findings from these comprehensive claims analyses provide compelling evidence that effective cost avoidance measures are readily available and can be implemented within existing state and commercial program structures. States and health plans can reduce unnecessary expenditures due to uncoordinated care, preserving valuable resources without reducing appropriate access to care or needed services. We can provide studies and research to advance efficiency, quality, program, policy and other objectives. Among other areas, this may be relevant in a variety of Federal and State grants and demonstration programs and research efforts.

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