PRIDE's Evolution: Provider Partnerships for Innovative Care, Phase 4

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People dually eligible for Medicare and Medicaid have among the highest health care needs and costs of any group, in large part because badly coordinated care has compromised their health outcomes. To address this poor coordination, The Commonwealth Fund has supported the learning collaborative Promoting Integrated Care for Dual Eligibles (PRIDE) since 2012. Under the first three phases of work, the collaborative identified the key attributes of high-performing health plans serving dual eligibles; convened a national advisory committee and selected seven successful plans to participate; initiated peer-learning and technical assistance efforts to help plans overcome the challenges of delivering integrated care on a large scale; and brought peer organizations together to share strategies for addressing the social determinants of health and leveraging value-based payments. For this fourth phase, the CHCS team will support up to 10 Medicaid health plans (six current and four new plans) to partner with care delivery systems to accelerate the adoption of proven or promising practices in care coordination for dual eligibles. The project's two components are: 1) providing support to the plans as they work with providers to adopt innovative practices; and 2) spreading knowledge from the learning collaborative and pilot projects to plans and providers not participating in PRIDE as well as to the broader health care community. Dissemination mechanisms will include an electronic "help desk" to answer questions about the pilots and conference calls with plan leaders trying to integrate care as well as successful PRIDE participants. This project will take advantage of core CHCS strengths: an ability to help stakeholders identify and deploy effective care improvement models, and a robust communications capacity for ensuring broad dissemination. It could foster improvements in the coordination and quality of care that dual eligibles in PRIDE plans receive and potentially could spur take-up of best practices by other plans and providers serving high-need, high-cost patients.

Grant Details

Grantee Organization:
Center for Health Care Strategies, Inc.
Principal Investigator:
Stephen Somers, Ph.D.
Award Amount:
$350,563.00
Approval Date:
November 14, 2017

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