Scale Is Not Optional: The Growth Imperative For Long-Term Viability is starting in

Medicare

The Medicare program is a health insurance program funded by the federal government for older adults, aged 65 and above, as well as younger individuals who have disabilities or end-stage renal disease. There are both strategic opportunities and challenges for health and human service provider organizations serving Medicare beneficiaries, who often have complex health and social support needs. As a result, Medicare plans are looking for innovative services and initiatives that demonstrate a return-on-investment in spending and consumer outcomes.


Among Medicare beneficiaries with mental health diagnoses, those who switched from Medicare Advantage to traditional Medicare in 2018 made more mental health visits after the switch, according to a recent study. Researchers conducted a longitudinal analysis of Medicare Advantage encounter data and traditional Medicare claims data from 2017 and 2018 for beneficiaries diagnosed with mental health disorders. The comparison focused on mental health utilization for the 12 months before and after beneficiaries switched from Medicare… Read