CMS’ dual-eligible demonstration update due
States may receive some insight from the CMS this week on the ambitious federal demonstration aimed at improving coordination of benefits and care for the nearly 9 million lowincome, elderly and disabled Americans who are dually eligible for Medicaid and Medicare.
During the Medicaid and CHIP Payment and Access Commission meeting Thursday, Tim Engelhardt, director of the CMS’ Medicare-Medicaid Coordination Office, will provide an update on federal-state initiatives taking place under the Financial Alignment Initiative. The commission is scheduled to release findings from focus groups of dual-eligible enrollees participating in the demonstrations in California, Massachusetts and Ohio.
Eleven states are running dual-eligi- ble demonstrations in which managed-care plans provide the full range of Medicaid and Medicare benefits and services for this vulnerable, expensive patient population. Last year, the National Association of Medicaid Directors sent a letter to the CMS asking about the uncertain future of the demonstrations. “States are eager to understand CMS’ long-range work plan for the demonstrations,” the group wrote. The CMS replied in January that it was “too early to make any conclusions about the success of the demonstrations.”
Patient advocates and health insurance plans involved in the demonstrations say it’s been tough to achieve cost-saving goals because beneficiaries’ participation is optional and many are opting out. Of the 1.7 million people eligible to participate in the 11 states, 343,355 had signed up as of April 1, according to Community Catalyst in Massachusetts.