Insurance, Entitlements, and Charity Care: The Business Case for Addressing the Health of Highly Vulnerable Populations, in Accountable Care News

Doug Hastings, Chair Emeritus of Epstein Becker Green, based in the Washington, DC, office, wrote an article titled "Insurance, Entitlements, and Charity Care: The Business Case for Addressing the Health of Highly Vulnerable Populations."

Following is an excerpt:

Responding to the health care needs and costs of the overlapping populations of those who are clinically at-risk or socially disadvantaged remains a fundamental moral and financial challenge in the United States. Among others, these populations include the frail elderly; the homeless; dual eligibles; low income individuals, especially within racial and ethnic minorities and rural Americans; at-risk young children; the mentally ill or cognitively impaired; and those with multiple or complex chronic conditions. For example, many beneficiaries who are dually eligible for Medicare and Medicaid are both economically disadvantaged (86% have incomes below 150% of the federal poverty level) and in poor health (60% have multiple chronic conditions).

Despite these challenges, it is with this highly vulnerable group that payment reform and coordinated care efforts have the biggest opportunity to improve quality of lives, lower costs, and reduce disparities. This is the natural extension of population health management, and is gaining greater attention as an important component of a value-based health care system. Progress will require coordinated federal, state, and private sector efforts—and legal support both through legislation and reduction of legal barriers—but the benefits to society and to these highly vulnerable individuals will be significant.

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