In their new Forefront article, Michael Monson and Sarah Barth of Altarum argue that the existing D-SNP model presents a template for how states could begin to create integrated environments for their dually eligible individuals in Medicare value-based care models.
"What could it look like? Imagine that a hospital running a Medicare Shared Savings Program (MSSP) has signed a State Medicaid Agency Contract (SMAC) with their state’s Medicaid program and that one of the MSSP’s participants, who has congestive heart failure, receives personal attendant care in their home (a service typically covered by Medicaid and not Medicare) for their activities of daily living (that is, activities related to personal care that include bathing or showering, eating, and dressing). Because the state required the hospital to create a model of care that included the personal attendant care agency in care planning, the hospital can incent that agency to provide daily weight readings on the participant (with the participant’s permission). When the sudden weight gain that often precedes a hospitalization for an individual with congestive heart failure is observed, the hospital can make a simple medical intervention to avoid an inpatient stay."
Read the full article here: https://bit.ly/3SRGWEG
