An­other in­surer will leave N.Y. Med­i­caid ini­tia­tive

Modern Healthcare - - REGIONAL NEWS - —Jonathan La­Man­tia, Crain’s New York Busi­ness

A fifth health in­surer has dropped out of an am­bi­tious but strug­gling Med­i­caid re­form pro­gram that tar­gets New York­ers with high med­i­cal costs.

The state-fed­eral ini­tia­tive, known as the Fully In­te­grated Du­als Ad­van­tage pro­gram, or FIDA, cov­ers low-in­come el­derly or dis­abled peo­ple who qual­ify for both Medi­care and Med­i­caid. There are 700,000 dual-el­i­gi­ble New York­ers, who drive a dis­pro­por­tion­ate share of Med­i­caid spend­ing in the state.

Af­ter strug­gling through FIDA’s first year, five plans won’t be offering the cov­er­age in 2016: ArchCare, Em­blemHealth, In­te­gra, Mon­te­fiore HMO and the most re­cent dropout, Em­pire Blue Cross and Blue Shield. Em­pire’s FIDA plan had only 275 mem­bers when it an­nounced its cov­er­age would end Dec. 31.

As of Nov. 2, the pro­gram had at­tracted only 7,540 peo­ple, well be­low state Health Depart­ment pro­jec­tions of 80,000 to 100,000 mem­bers. About a year ago, the state awarded 22 con­tracts to in­sur­ers, po­ten­tially worth a to­tal of $14.6 bil­lion.

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