Elder Health Program in Baltimore Achieves Better Outcomes for Low-Income Elderly Through a Capitated System

Evaluation of a capitated health care system for low-income elderly Baltimore residents

From 1998 to 2000, researchers at the Johns Hopkins University, Bloomberg School of Public Health studied Elder Health, a for-profit managed-care provider in Baltimore, Md., that serves individuals eligible for both Medicare and Medicaid (i.e., dually eligible).

Key Findings

In journal articles in Health Care Financing Review and the Journal of the American Geriatrics Society, and in unpublished reports to RWJF, the investigators concluded that:

  • Elder Health offers a model of care that may be unique. Among its distinctive elements are that:
    • It is a for-profit organization that provides comprehensive care for a population of patients that typically uses a large quantity of health care resources.
    • It combines Medicare and Medicaid capitation payments at the health care provider level, thereby allowing discretion in how funds are spent.
    • Each Elder Health patient is assigned a nurse practitioner functioning as a case manager who integrates medical care and social services as needed, and a nurse practitioner who is available on-call 24 hours a day, 7 days a week.
  • Elder Health patients appeared to experience equal or better health outcomes than do those in a matched sample of older adults in the fee-for-service sector.
  • Elder Health patients expressed greater satisfaction with their access to care and receive more primary care and preventive services at comparable cost.

Funding

The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $352,436.

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