The Minnesota Senior Health Options demonstration integrates Medicare and Medicaid primary, acute and long term care financing and service delivery for dually eligible seniors. MSHO has been operating since 1997 and has an enrollment of 3,400 in 3 health plans operating in 5 counties. The goals of the demonstration are to align fiscal incentives, reorganize service delivery systems and provide a single point of accountability for care and service outcomes to dually eligible seniors residing in both community and institutional settings. The financial pressures on Medicare and Medicaid due to the aging of the baby boom population require long term investment in more efficient models of chronic care delivery for dual eligibles whose costs comprise about one-third of health care spending for states and the federal government. Yet a number of states that have pursued development of integrated demonstrations have encountered many difficulties in obtaining waivers and attracting providers so few such demonstrations have actually become operational. As a result there has been considerable national interest in monitoring the progress of the MSHO demonstration. This session will focus on key findings thus far in the demonstration. We will present and discuss the results derived from: satisfaction surveys, HEDIS and other utilization data, enrollee and provider focus groups and clinical forums as well as the efforts of a clinical workgroup of medical directors and clinicians from care systems and health plans working with the state on best practice models.
Learning Objectives: At the end of this session the participants will: 1) Be able to explain what MSHO is; 2) Be able to identify and articulate key outcomes of the demonstration to date
Keywords: Medicare/Medicaid, Outcome Measures
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.