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Voices for Better Health Pilot Project
Improving Care for the Most Vulnerable Older Adults and People with Disabilities

Picture10 Million Suffer from Poor Care and Case Management
There are over 10 million people in the country -- 126,000 in Washington State -- who are eligible for both Medicare and Medicaid. “Dual eligibles” have trouble navigating through a complicated maze of multiple doctors, medications and programs. They bounce in and out of emergency rooms, hospitals and nursing homes, experiencing poor care and unnecessary complications. The price tag for this ineffective care is massive: more than $300 billion annually nationally, estimated over $2 billion in Washington State.

PictureOptions for Better Health
The Affordable Care Act has launched initiatives to allow states to develop innovative ways to provide better coordinated, comprehensive, high quality care to dual eligibles. The Alzheimer's Association Western and Central Washington State is partnering with Community Catalyst, a national nonprofit consumer health advocacy organization with a long history of working to improve systems of care for dual eligibles to shape the design of these initiatives so they best serve the needs of this unique population. This means:

  • Allowing patients to choose plans or providers that can best serve their needs

  • Emphasizing community and home-based services over institutional care

  • Creating payment rates that ensure the needs of those with the most complex conditions are met

  • Respecting the cultural and linguistic needs of patients and caregivers

If designed well, these initiatives can help reduce preventable hospital and nursing home admissions and improve dual eligibles' overall health and quality of life.

Advancing State and Federal Policy on Care for Dual Eligibles
State and federal policymakers particularly concerned about the high costs of care for dual eligibles hope these initiatives will produce significant cost savings. While this is an important goal, there is the risk that the drive to save money will overshadow the goal of achieving better quality care. Voices for Better Health will work to educate policymakers and other key stakeholders about what's needed to improve outcomes, save money and protect dual eligibles. It will also equip consumer advocates with the resources and expertise necessary to establish a seat at the table for themselves and dual eligibles and their caregivers as this important policy debate takes shape.

Engaging Consumers
One of the keys to creating a successful health care delivery system for dual eligibles is developing meaningful ways of soliciting the input of those being served. Voices for Better Health is working with new delivery systems – health plans and provider groups -- to develop these approaches, from member meetings to consumer advisory councils to including consumers on governing boards.

For more information, contact Keri Pollock, Communications Director at kpollock@alz.org

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