News & Updates

High-Risk Care Coordination Reduces Cost and Improves Outcomes in Medicaid

June 29, 2020

High-Risk Care Coordination Reduces Cost and Improves Outcomes in Medicaid

Washington, DC—The Institute for Medicaid Innovation (IMI), the nonprofit, nonpartisan Medicaid research group, released findings from their annual Medicaid managed care organization (MCO) survey report exploring the impact of high-risk care coordination in the Medicaid population. Care coordination interventions have been associated with improved satisfaction and experiences for participants, fewer inpatient admissions, reductions in unnecessary care, and improved health outcomes.

The report highlights several approaches led by managed care organizations for care coordination, with the most common being the creation of a shared care plan among clinicians, case managers, and the enrollee. Other common approaches included providing support for adherence to the care plan and conducting individual-level risk assessments. The report features three case studies of innovative initiatives that are led by UPMC Health Plan, UnitedHealthcare Community & State, and Kern Health Systems. The publication also identified challenges to implementation of care coordination. Fifty-six percent (56%) of MCOs reported frequent challenges accessing information from discharging provider. Ninety-five percent (95%) of MCOs reported inaccurate member information as a major barrier to care coordination activities. In addition to highlighting the key components of care coordination programs, common payment mechanisms, and potential barriers to successful implementation, the report provides clinical, research, and policy opportunities that could improve the quality of and access to care coordination services.

Read the full report and download the infographic on high-risk care coordination.


About the Institute for Medicaid Innovation

The Institute for Medicaid Innovation (IMI) is a 501(c)3 nonprofit, nonpartisan research and policy organization that provides independent, nonpartisan information and analysis to inform Medicaid policy and improve the health of the nation.


Media Contact

Lydia Tonkonow