Population health initiatives typically assume that members can participate in their own care on a basic level, yet those assumptions may not hold true for Medicare and Medicaid members. Their lives typically differ from the lives of those with commercial insurance, which makes cost-effective care management uniquely challenging—and even more important.

Keeping Medicare and Medicaid populations healthy and avoiding adverse events may require care managers to think—and manage—beyond the realms of traditional care delivery. Success will ultimately lie in educating and connecting with members at a personal level to build realistic care plans that yield better outcomes at lower costs.

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