Dealing with the Issue of Fragmented Health Care

People with special health care needs can need extra help in navigating through the complexities of the health care system. For Medicare beneficiaries with chronic illnesses, this may involve coordinating the care received from multiple providers, in order to prevent adverse health consequences. Care coordination can also involve breaking down boundaries between systems of care and helping clients with daily routines and service needs.

In a five-year project, we are evaluating 17 independent care coordination demonstrations for Medicare beneficiaries with chronic illnesses. These programs offer services to improve the care clients receive as well as their knowledge of and compliance with recommended self-care and behavior. Using a randomized design, the study is estimating effects on their well-being and satisfaction, as well as on the use and cost of Medicare-covered services. We are also documenting the interventions and factors that affect program success.

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