Healthcare Business News

Mass. first state to join dual-eligibles care demo

By Paul Barr
Posted: August 23, 2012 - 8:00 pm ET

Massachusetts is the first state to join a CMS demonstration project focused on providing better-coordinated patient-centered care to people enrolled in both Medicare and Medicaid, the CMS announced.

Massachusetts entered into a memorandum of understanding with the CMS to join what is called the Financial Alignment demonstration, which calls for both to contract with a designated integrated-care organization that would be in charge of coordinating the care for the 110,000 dual eligibles in the state, according to a news release.

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The goal is to improve care, make it easier for patients to navigate Medicare and Medicaid programs and save money, according to the release. The project will test capitated and managed fee-for-service models.

In July, Melanie Bella, director of the Medicare-Medicaid Coordination Office at the CMS, told a congressional committee that it would not expand the program, as some groups had feared, despite the popularity of the project among states applying to join. Some were concerned that a huge pilot would overwhelm the CMS' ability to run the project properly, and could have negative effects on enrollees.

As Bella said would happen, the CMS kept a feature that automatically enrolls eligible beneficiaries, giving them the choice to opt out. Those beneficiaries will be enrolled in July and October of 2013 after volunteers for the program are allowed to join in April of that year.

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