One Care: A Worthwhile Work in Progress

November 25, 2014 § Leave a comment

By Robert J. Master, MD,  Chief Executive Officer of Commonwealth Care Alliance 

As one of the three organizations in the state involved in the One Care program, Commonwealth Care Alliance was pleased to see Kay Lazar’s story in the November 10 Boston Globe. The article described the challenges involved in caring for some of society’s most vulnerable, medically complex, and poorly served individuals; touched on the complexities of this first-in-the-nation demonstration program; and brought much-needed attention to the policy imperative for this cornerstone initiative of the Patrick Administration and a key reform of the Affordable Care Act.

Individuals eligible for One Care experience an array of disabilities due to injury, multiple chronic health conditions, serious mental illnesses, or alcohol and substance abuse addictions. Some are homeless; others are homebound. But until One Care, few were receiving the person-centered, coordinated care that they desperately needed.  Medicare and Medicaid created this program to redress the care delivery failure and to answer the question, “How do we reign in the unsustainable costs for this very high needs population where past ‘managed care’ strategies and fragmented fee-for-service care delivery have failed?”

Of course there are unprecedented risks and challenges. Of course there are requirements for large initial investments because of long-deferred unmet needs and decades of underinvestment in community-based care that promotes autonomy and provides alternatives to hospital and institutional care.

This isn’t easy. If it were, we would have done this decades ago. I’m proud that Massachusetts is leading this long-overdue national care delivery transformation that is already showing positive results, and I am honored that Commonwealth Care Alliance is able to play such an important part in this effort.



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