Promoting Integrated and Coordinated Care that Addresses Social Risk for the Dual Eligible Beneficiary Population, 2017 

This report is the Measure Applications Partnership’s (MAP’s) latest set of recommendations to the U.S. Department of Health and Human Services (HHS) for performance measures that can improve healthcare services and value for individuals eligible for both Medicare and Medicaid. These beneficiaries are some of the most vulnerable individuals accessing the healthcare system and supportive services, often experiencing disabling disease and complex social circumstances with limited resources. MAP supports the removal of eight measures from the Dual Eligible Beneficiaries Family of Measures as well as the addition of five measures to the Family. MAP discusses strategic issues including the need for a paradigm shift in measure conceptualization and development, using a population and person-centered approach. MAP encourages coordination among stakeholders developing dual eligible beneficiary survey instruments. Additionally, MAP identifies 11 social risk factors that underscore the complexity of the population and recommends that measures should account for and address these identified factors.