OM: Half of States Planning A Dual-Eligible Pilot Program Having Second Thoughts

Half States Planning A Dual-Eligible Pilot Program Having Second Thoughts

Open Minds  June 24, 2013

 

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Fifteen of the the 26 states that applied to operate a demonstration project to align reimbursement and service delivery systems to coordinate care for people eligible for both Medicare and Medicaid (dual eligibles) have cancelled the projects, are changing the projects, or delaying implementation. Three states have dropped out-Arizona, New Mexico, and Tennessee. Three states are working to change their proposals to other projects outside the Centers for Medicare and Medicaid Services financial alignment demonstration-Minnesota, Oregon, and Wisconsin. Of the nine that are delaying their projects, three have already received CMS approval to begin-California, Massachusetts, and Washington. The remaining states planning to delay the start date have not received CMS approvals-Hawaii, Iowa, Michigan, Missouri, New York, and Vermont.

 

The status of the dual eligible demonstrations is posted on the Centers for Medicare and Medicaid Services website at www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialModelstoSupportStatesEffortsinCareCoordination.html (accessed June 20, 2013).

 

The status of the remaining 11 states planning a financial alignment demonstration for dual eligibles is as follows:

1. Colorado-managed fee-for-service (FFS)-enrollment to start by October 2013-CMS has not yet granted approval
2. Connecticut-managed FFS-planned enrollment date has not been announced-CMS has not yet granted approval
3. Illinois-capitated-enrollment to start by October 1, 2013-CMS has granted approval
4. Idaho-capitated-enrollment to start by April 1, 2014-CMS has not yet granted approval
5. North Carolina-managed FFS-planned enrollment date has not been announced-CMS has not yet granted approval
6. Ohio-capitated-enrollment to start by September 1, 2013-CMS has not yet granted approval
7. Oklahoma-managed FFS-enrollment to start by July 1, 2013-CMS has not yet granted approval
8. Rhode Island-capitated-enrollment to start by September 1, 2013-CMS has not yet granted approval
9. South Carolina-capitated-enrollment to start by January 1, 2014-CMS has not yet granted approval
10. Texas-capitated-enrollment to start by January 1, 2014-CMS has not yet granted approval
11. Virginia-capitated-enrollment to start by January 1, 2014-CMS has granted approval

 

OPEN MINDS also reported on this topic in “34 States Integrating Medicare & Medicaid Services For Dual Eligibles.” The article is available at www.openminds.com/market-intelligence/premium/omol/2013/041513ds4.htm. 

For more information, contact: Emma Sandoe, Media Contact, Centers for Medicare and Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244; E-mail: emma.sandoe@cms.hhs.gov; Website:www.cms.gov. 

Half States Planning A Dual-Eligible Pilot Program Having Second Thoughts. (2013, June 10). OPEN MINDS Weekly News Wire.

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