The American Hospital Association Committee on Research each year conducts an in-depth examination of a topic to provide the hospital field with recommendations for advancing health care. Last year, the committee examined emerging hospital-centered practices for effective care coordination for vulnerable populations. Since the breadth of the vulnerable population is large, the committee focused its initial efforts on the unique "dual-eligible" population as a subset.

Currently, care for the nearly 9.2 dual eligibles — low-income seniors and younger persons with disabilities who are enrolled in both Medicare and Medicaid — is fragmented, unmanaged and uncoordinated at the program level, based on an inefficient fee-for-service payment system. Dual eligibles are among the sickest and poorest individuals, and they must navigate both government programs to access services, relying on Medicaid to pay Medicare premiums and cost sharing to cover critical benefits not covered by Medicare.

Hospitals are in the unique position to address the system, provider and patient barriers impeding high-quality care. The committee's report, "Caring for Vulnerable Populations," summarizes the literature, highlights best practices and recommends important elements that should be included in any organized program to coordinate care for the dual-eligible or any other vulnerable population. The report can be accessed at

I believe you will find this report valuable as your organization discusses plans to implement future care coordination programs for dual eligibles and other vulnerable populations.

This report is only the beginning of AHA's discussion on improving care for vulnerable populations. There will be an executive briefing on this topic at the 2012 AHA Annual Membership Meeting, May 6-9 in Washington, D.C. For more details, visit

The AHA also plans to highlight other examples of care planning for vulnerable populations through case studies and reports available on its Hospitals in Pursuit of Excellence website, and would like to hear more about what your organization is doing. To submit a case study, please go to

Kimberly McNally ( is COG chair and a trustee of Harborview Medical Center/UW Medicine in Seattle.