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Strategy for improving health care for uninsured, low-income, and minorities in the US
Date:10/6/2011

tworks of providers for providing optimal care for Medicaid beneficiaries, more equitable Medicaid payment rates, and developing the workforce needed to care for vulnerable populations.

  • Stabilize health insurance coverage. The report recommends limiting gaps and disruptions in health insurance that come from job or income changes by actions such as guaranteeing year-long coverage periods, providing access to the same insurance plans in exchanges and in Medicaid, merging small-group and individual health insurance exchanges, coordinating eligibility and enrollment for all forms of subsidized insurance through the exchanges, and ensuring that adequate numbers of essential community providers are included in both Medicaid and the subsidized plans.

  • Limit out-of-pocket health care costs. The Commission recommends protecting consumersparticularly low-income families who may struggle with out-of-pocket costs despite affordable premiumsfrom excessive out-of-pocket health care costs through insurance benefit designs with incentives to use effective care and reasonable income-related limits on overall out-of-pocket spending.

  • Ensure the financial stability of the safety net while stimulating higher performance. Ensure adequate funding for the safety-net system to continue to provide services to vulnerable populations, and use those financial resources to stimulate and reward higher performance.

  • Promote greater clinical integration in safety-net care systems. Payment reform and regulatory changes that explicitly encourage collaboration and affiliation should be used to encourage providers to work together across health care settings and assure coordinated care for patients. In addition, safety-net providers should be encouraged to participate in accountable care systems that serve vulnerable groups.

  • Focus on comprehensive, coordinated, team-based primary care for all providers serving vulnerable populations. The r
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  • Contact: Mary Mahon
    mm@cmwf.org
    212-606-3853
    Commonwealth Fund
    Source:Eurekalert

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