Persons enrolled in both Medicare and Medicaid, known as dual eligibles, are some of the high costs of the beneficiaries in the United States. Commonwealth Care Alliance, a small non-profit insurer and the health care system in Massachusetts, performed in the framework of the program of public demonstrations designed to provide full coverage and care for the elderly dual rights of the population. Under the direction of Dr. Robert Master, Commonwealth Care Alliance has worked with its contracted providers to implement and support the model of care, which may allow as many members as possible in order to live independently outside the nursing home. The case examines the Commonwealth Care Alliance Insurance and health care approach amid the changing political environment and different resources. This case can be used for learning: approaches to value-based insurance and health care, insurance and health care considerations not the high cost of the population, evolution and structure of the U.S. Medicare and Medicaid program status and demonstrations, as well as the payer and provider reimbursement models. "Hide
by Michael E. Porter, Jennifer F. Baron Source: Harvard Business School 25 pages. Publication Date: April 1, 2008. Prod. #: 708502-PDF-ENG