Skip to Main Content

RTI uses cookies to offer you the best experience online. By and clicking “accept” on this website, you opt in and you agree to the use of cookies. If you would like to know more about how RTI uses cookies and how to manage them please view our Privacy Policy here. You can “opt out” or change your mind by visiting: http://optout.aboutads.info/. Click “accept” to agree.

Accept
RTI International
  • About
    • Office Locations
    • Executive Leadership
    • Corporate Governance
    • Partner with Us
      • U.S. Government
      • Clients and Funding Agencies
      • Industry and Commercial Clients
      • Foundations and Associations
      • Bilateral Agencies and Multilateral Banks
      • Universities and Academic Research Institutions
      • Suppliers and Small Businesses
    • Commitment to Quality
      • RTI's Client Listening Program
    • Ethics and Human Research Protection
    • Living Our Mission
    • Veteran Opportunities at RTI

    About

  • Practice Areas
    • Health
      • Public Health and Well-Being
      • Health Care Transformation
      • Behavioral Health
      • Health Behavior Change
      • Precision Medicine
      • RTI Health Solutions (RTI-HS)
      • RTI Center for Community Health Evaluation and Economics Research
      • Health Equity
      • RTI Health Advance
    • Transformative Research Unit for Equity​
      • Equity Capacity Building Hub
      • Social and Economic Justice Research Collaborative
      • Narrative Research and Community Engagement Lab
    • Education and Workforce Development
      • Early Childhood
      • K-12 Education
      • Postsecondary Education
      • Career and Adult Education and Workforce Development
      • Education Policy, Systems, and Governance
      • Education Research Methodologies
      • Education Technologies
    • International Development
      • Energy for Development
      • Environment
      • Global Food Security, Agriculture, and Nutrition
      • Global Health
      • International Education
      • Monitoring, Evaluation, Research, Learning, and Adapting (MERLA)
      • Youth and Economic Opportunity
      • Building Resilience Against COVID-19 in Developing Countries
      • Water, Sanitation, and Hygiene (WASH)
      • RTI Center for Governance
    • Climate Change
      • Clean Energy Technology and Renewables
      • Climate Finance
      • Climate Justice and Equity
      • Climate Planning, Preparedness and Resilience
      • Climate Policy
      • Climate Vulnerability, Adaptation, and Mitigation
      • Economic Impacts of Climate Change
    • Water
      • Food-Energy-Water Nexus
      • Water Quality
      • WASH (Water, Sanitation, Hygiene)
      • Water Resources Management
    • Energy Research
      • Carbon Capture and Utilization
      • Biomass Conversion
      • Natural Gas
      • Energy Efficiency
      • Industrial Water
      • Syngas Processing
    • Environmental Sciences
      • Air Quality
      • RTI Center for Water Resources
      • Urban Sustainability
      • Toxics
      • Building Resiliency in the FEW Nexus
      • Climate Change Sciences and Analysis
      • Environmental Policy
      • Environmental Justice
      • Sustainable Materials & Waste Management Solutions
    • Justice Research and Policy
      • RTI Center for Community Safety and Crime Prevention
      • RTI Center for Policing Research and Investigative Science
      • Child Well-Being and Family Strengthening
      • RTI Center for Forensic Sciences
    • Food Security and Agriculture
      • Market Systems Strengthening
      • Food Safety
      • Food and Nutrition
      • Global Food Security, Agriculture, and Nutrition
      • Climate-Smart Agriculture
      • Agricultural Innovation
      • Obesity Prevention
    • Innovation Ecosystems
      • Innovation Advising
      • Innovation for Economic Growth
      • Innovation for Emerging and Developing Economies
      • Innovation for Organizations
      • Research, Technology, and Innovation Policy
      • Technology Acceleration
    • Military Support
      • Military Behavioral Health
      • Military Health and Human Performance
      • Military Sexual Assault, Harassment, and Domestic Violence Prevention
      • Wearable Sensor Technologies
      • Military Health System Transformation

    Practice Areas

  • Services + Capabilities
    • Surveys and Data Collection
      • Survey Design
      • Instrument Development
      • Survey Methodologies
      • Data Collection
      • Establishment Surveys
      • Health Registries
      • Data Analysis and Reporting
      • Research Operations Center
    • Statistics and Data Science
      • Survey Statistics
      • Environmental Statistics
      • Coordinating Centers for Multisite Studies
      • Analysis and Design of Complex Data
      • Biostatistics
      • RTI Center for Data Science
    • Evaluation, Assessment and Analysis
      • Evaluation Design and Execution
      • Advanced Qualitative, Quantitative, and Mixed Methods
      • Evaluation, Monitoring, and Assessment
      • Economic Analysis
      • Evaluating Communication Interventions and Campaigns
      • Evidence Synthesis for Policy and Practice
      • Risk Assessment and Prediction
    • Program Design and Implementation
      • Systems Strengthening and Scaling
      • Capacity Assessment and Building
      • Policy Reform Support
      • Curriculum and Teacher Professional Development
      • Interventions and Prevention Programs
      • Implementation Science
    • Digital Solutions for Social Impact
      • Human-Centered Design of Digital Solutions
      • Digital Product Development
      • Digital Communication Campaigns
      • Digital Data Analytics
    • Research Technologies
      • Survey Technologies
      • Data Management and Decision Support Systems
      • Geospatial Science, Technology, and Visualization
      • ICT for Limited-Resource Settings
      • Mobile Applications
      • Web Applications
      • Bioinformatics
      • Interactive Computing
    • Drug Discovery and Development
      • Medicinal Chemistry
      • Molecular Design and Cheminformatics
      • Behavioral Pharmacology
      • Drug Metabolism and Pharmacokinetics (DMPK)
      • In Vitro Pharmacology, Bioassay Development, and High-Throughput Screening (HTS)
      • Isotope Labeling
      • Regulatory Consulting and Support for Medical Products
    • Analytical Laboratory Sciences
      • Bioanalytical and Toxicology Research
      • Forensic Sciences
      • Physicochemical Characterizations
      • Metabolomics
      • Proficiency Testing and Reference Materials
      • Microbiology
      • Analytical Chemistry and Pharmaceutics
    • Engineering & Technology R&D
      • Biomedical Technologies
      • Decarbonization Sciences
      • Environmental Exposure & Protection
      • Materials & Environment
      • Sustainable Energy Solutions

    Services + Capabilities

  • Centers
    • RTI Center for Advanced Methods Development
    • RTI Center for Communication Science
      • Communication Research
      • Communication Design
      • Communication Delivery
    • RTI Center for Data Science
    • RTI Center for Education Services
      • Teaching and Learning
      • Education Leadership
      • Peer Learning Networks
      • Strategic Consulting
    • RTI Center for Forensic Sciences
    • RTI Center for Global Noncommunicable Diseases
      • Program Financing & Economics for NCDs
      • Health Systems Strengthening for NCDs
      • Communication Science and Behavior Change for NCDs
      • Implementation Science for NCDs
    • RTI GenOmics, Bioinformatics, and Translational Research Center
      • Disability Studies
      • Ethics
      • Newborn Screening
    • RTI Center for Water Resources
      • Water Resources Sectors
      • Water Resources Services
      • Water Resources Tools
    • RTI Center for Governance
    • RTI Global Gender Center
    • North Carolina Center for Optimizing Military Performance
    • NCCU-RTI Center for Applied Research in Environmental Sciences
    • RTI Center for Climate Solutions

    Centers

  • Impact
    • Newsroom
    • Insights Blog
    • Events
    • Publications
    • RTI Press
      • About the RTI Press
      • Instructions for Authors
      • RTI Press Collections
    • Projects
    • Global Reach
      • Asia
      • Eastern Europe and Central Asia
      • RTI International India
      • Africa
      • Middle East and North Africa (MENA)
      • Latin America and the Caribbean (LAC)

    Impact

  • Experts
    • Our Experts
    • In-Depth With Our Experts
    • Related News
    • Experts In the Media
    • RTI Fellow Program

    Experts

  • Emerging Issues
    • COVID-19 Research
    • Artificial Intelligence
    • Global Health Security
    • Cannabis Research
    • Opioid Research
      • Interventions for Opioid Use Disorders
      • Preventing Opioid Misuse and Overdose
      • Treating Opioid Use Disorders
    • Policing Research and Investigative Science
    • Drone Research and Application
    • E-cigarette Research
    • Zika Virus Research
    • Integrated Governance

    Emerging Issues

  • COVID-19 Research + Response
  • Global Reach
  • Insights Blog
  • Newsroom
  • RTI Press
  • Publications
  • Partner With Us
  • Careers
  • Facebook IconTwitter IconInstagram IconYouTube IconLinkedin Icon
  • Home
  • Impact
  • Newsroom
  • New research shows efforts to improve Medicare and Medicaid programs are working
Newsroom

New research shows efforts to improve Medicare and Medicaid programs are working

March 21, 2017
Share
  • Share on Facebook
  • Share on Twitter
  • Share on Linkedin
  • Email

RESEARCH TRIANGLE PARK, NC -- Efforts to improve care and reduce costs for Medicare and Medicaid patients are showing promise, according to new results reported in three issue briefs by RTI International.

The Centers for Medicare and Medicaid Services’ (CMS) Medicare-Medicaid Coordination Office and Center for Medicare and Medicaid Innovation (CMMI) are running demonstration projects in thirteen states as part of their Financial Alignment Initiative.

The initiative is working to develop coordinated care delivery models that integrate primary care, acute care, behavioral health, and long-term support services for Medicare-Medicaid enrollees to improve the quality of care, enhance the patient experience and reduce costs. The patients involved are low income and age 65 and over or under age 65 with disabilities. As a result, they frequently suffer from multiple ailments, including heart disease, diabetes, arthritis, or a serious mental illness; may be frail; and need frequent or long-term care.

“People with both Medicare and Medicaid often have complex medical and supportive service needs but may not know where to turn for help navigating the health care system, to access the care they need, or to improve their health,” said Edie Walsh, the director of the RTI evaluation of these demonstrations.

Walsh continued, “Care coordinators can fill this gap, working with Medicare-Medicaid patients to identify their health care needs, set health goals, and access resources to achieve the goals. The result can include more engaged patients, better health outcomes, and lower health care costs, for example, by helping people decrease their need for emergency room visits and hospitalization.” 

CMS contracted with RTI and its partners at the University of Southern Maine, the National Academy for State Health Policy, the Urban Institute, Actuarial Research Corporation, The Henne Group, the American Institutes for Research, and the Center for Health Care Strategies to:

  • Monitor the implementation of demonstrations
  • Evaluate the impact on the patient experience
  • Monitor and evaluate the impact on the population overall
  • Monitor and evaluate the impact on specific population subsets (e.g., those with mental illness and/or substance use disorders and long-term support services users)

These three RTI’s reviews of the demonstrations indicate the Financial Alignment Initiative is showing potential for meeting CMMI’s goals. Participating states largely have been able to overcome major design and operational challenges to implement new care coordination approaches.  Managed care plans in these states have hired and trained care coordinators who work with enrollees to assist them in better managing their care and health needs.

Enrollees in five states indicated in focus groups that they have noticed positive changes in the programs, including greater access to a broader and more flexible range of services.

One woman in Washington said during one focus group that she used to visit the emergency room three to four times a week for little things. “Since I started with (my care coordinator), over the last two years, I’ve been to the (emergency room) once in two years,” she said.

However, focus group participants noted challenges remain—including communication about patient benefits, rights, and protections; access to providers, pharmacies, and supplies; and concerns about the quality and accessibility of non-emergency medical transportation.

Lastly, demonstrations in Washington and Massachusetts showed progress in meeting the needs of racial and ethnic minority patients with complex health issues, such as multiple chronic diseases or persistent mental illness, and patients expressed satisfaction with the services provided by care coordinators. Spanish-speaking enrollees also indicated a preference for providers and materials in Spanish.

The demonstrations under the Financial Alignment Initiative are scheduled to continue for several more years, and RTI and its partners will continue to monitor and report on the impact of the initiatives.

To learn more about the projects, read the three issue briefs:

  • Early Findings on Care Coordination in Capitated Medicare-Medicaid Plans under the Financial Alignment Initiative
  • Issue Brief: Special Populations Enrolled in Demonstrations under the Financial Alignment Initiative
  • Beneficiary Experience: Early Findings from Focus Groups with Enrollees Participating in the Financial Alignment Initiative

Additional reports are also available on the CMS website. 

Highlights

  • Efforts to improve care and reduce costs for Medicare and Medicaid patients are showing promise, according to new results reported in three issue briefs by RTI International.
  • The Centers for Medicare and Medicaid Services’ Medicare-Medicaid Coordination Office and Center for Medicare and Medicaid Innovation are running demonstration projects in thirteen states as part of their Financial Alignment Initiative
  • RTI’s reviews of the demonstrations indicate the Financial Alignment Initiative is showing potential for meeting CMMI’s goals

Meet the Experts

Edith G. Walsh Senior Director

Media Info

To request an interview, contact our Media Relations team.

  • +1 919 708 8205
  • news@rti.org
Subscribe to RTI

RTI Logo
Partner With Us
  • US Government
  • Commercial
  • Foundations & Associations
  • Multilateral Donors
  • Universities
  • Suppliers
Site
  • Privacy Policy
  • Security Policy
  • Site Map
  • Terms of Use
  • Accessibility
  • Contact Us
Contact Us
Facebook Icon Twitter Icon Instagram Icon YouTube Icon Linkedin Icon
delivering the promise of science
for global good
RTI Health Solutions RTI Innovation Advisors RTI Health Advance

© 2023 RTI International. RTI International is a trade name of Research Triangle Institute. RTI and the RTI logo are U.S. registered trademarks of Research Triangle Institute.