Patients Give High Marks to Dual-Eligible Medicaid/Medicare Program in Michigan

October 28, 2019

CMS recently released an evaluation of the Michigan Department of Health and Human Services’ MI Health Link program—a health care plan for dually-eligible beneficiaries that aims to improve care through better care coordination and integration of health services—and found that patients are highly satisfied with the results.

Funded as a CMS demonstration project, the MI Health Link program improves quality of care for the “dually-eligible,” those who are eligible for both Medicare and Medicaid. Duals represent a small segment of the Medicaid population but their often complex care needs account for a relatively large share of health spending.

Altarum played a role in enabling the success of the initiative by leading the development of an electronic referral document. The referral document is exchanged between the Integrated Care Organizations, coordinating care for the beneficiaries, and the organizations providing behavioral health services, the Prepaid Inpatient Health Plans (PIHPs). The referral includes a comprehensive set of both physical and behavioral health information enabling quicker referrals and improved access to behavioral health services.

Patients reported satisfaction with their improved access to additional benefits, services, and quality health providers while having to pay no out-of-pocket costs for their medical care. They also reported satisfaction with their prescription drug coverage and with coordinators who keep their care on track.

The referral document, a C-CDA (consolidated-clinical document architecture), has been enhanced and standardized by Altarum to include all of the necessary information needed for a person-centered care plan. The care plan can be electronically exchanged and viewed by the beneficiary and the care team members.

Patient satisfaction isn’t the only positive result of the project. Another recent evaluation of MI Health Link commissioned by CMS found that the plan has succeeded in reducing the probability of inpatient admissions and in preventable emergency room visits. The report also stated that PIHP’s “receive much more information about enrollees’ physical health than before the demonstration.”

Learn more about Altarum’s role in this innovative program, and contact us to learn how our interoperability services and tools can facilitate care coordination in your community or state.

Altarum is a nonprofit organization that works with federal and state agencies and foundations to design and implement solutions to improve the health of individuals with fewer financial resources and populations disenfranchised by the health care system. We achieve measurable results by combining our expertise in public health and health care delivery with technology, workforce training and continuing education, applied research, and technical assistance. Our innovative solutions lead to better health for beneficiaries and better value for payers.