More than half of the states that applied to participate in the controversial CMS demonstration have either dropped out or delayed their programs, according to the CMS and health policy experts.
Among the 26 states that applied to enroll 3 million beneficiaries in the CMS Financial Alignment Initiative, six have dropped out or opted for different “customized” plans and nine have delayed their start dates. The ambitious program was authorized by the Patient Protection and Affordable Care Act.
Dual-eligibles make up 15% of Medicaid enrollees and consume 39% of its expenditures, said Melanie Bella, director of the Medicare-Medicaid Coordination Office at the CMS. Likewise, dual-eligibles account for 18% of Medicare beneficiaries and 31% of its budget.
Advocates for beneficiaries and providers have criticized the state projects for their size, scope and aggressive timeframes, which had some starting as soon as early 2013 and the rest by January 2014.
But none may launch this year and few by early next year. “The timelines were always too ambitious; it's taking even longer to get stuff set up than they thought it would,” said Kevin Prindiville, deputy director of the National Senior Citizens Law Center.