Melanie Bella, director of the Medicare-Medicaid Coordination Office at the CMS, has announced she plans to leave the agency.
Her announcement comes within two weeks of Cindy Mann, CMS' deputy administrator and director of the Center for Medicaid and Children's Health Insurance Program Services, announcing she was departing the agency.
At MMCO, Bella oversees coordinating care for Americans covered by both Medicare and Medicaid. She joined the agency in 2010 following stints as a senior vice president for policy and operations at the Center for Health Care Strategies, a not-for-profit quality improvement organization based in Hamilton, N.J., and as director of Indiana's state Medicaid program.
Just over 9 million dual-eligibles account for 40% of all Medicaid spending and 27% of all Medicare spending, with their care costs totaling about $350 billion a year. Bella was brought on in the hopes she could help spearhead initiatives to better coordinate care for these individuals and reduce the cost of their care.
“It has been an amazing opportunity to be part of building the Medicare-Medicaid Coordination Office, and I'm proud of what all we have accomplished to make Medicare and Medicaid work better for the people who depend on these programs,” Bella said in an e-mail sent Tuesday to staff.
“I'm confident that the MMCO team will seamlessly carry on this critical work, in partnership with states and other key stakeholders, and continue making progress to improve access, quality and costs for Medicare-Medicaid enrollees.”
She did not announce when her departure would take place, but did say once she leaves, Tim Engelhardt, one of her deputies, will take over as acting director.
Under Bella's leadership, California, Illinois, Massachusetts, Ohio and Virginia have opted to launch coordinated-care demonstrations. Demonstrations are also slated to begin in the coming months in Michigan, New York, South Carolina, Texas and Washington.
“States are certainly frustrated with CMS' slow and rigid approach to integrating Medicare and Medicaid for dual-eligibles,” said Kip Piper a Washington-area consultant and former senior official at the CMS. “But we'd be nowhere if it wasn't for Melanie and her team. They had to overcome extraordinary obstacles.”
In November, Bella said the agency had uncovered evidence that some healthcare providers are illegitimately trying to dissuade dual-eligible beneficiaries from participating in the dual demonstrations. The CMS had increased its surveillance of these providers, she said, though she did not specifically identify any.
“We are unfortunately seeing lots of bad behavior in most of the states,” she said during the National Association of Medicaid Directors conference Nov. 4. “Providers and other plans are telling beneficiaries they are going to lose benefits or lose prescription drug coverage.”
Bella did not provide specific examples but said providers are obstructing the care-coordination demonstration by scaring the beneficiaries and leading them to opt out of participating. The information the providers are giving beneficiaries is often inaccurate or misleading, she said. Beneficiary participation in the demonstrations is voluntary.
The CMS did not respond to a request for comment on Bella's departure.
Follow Virgil Dickson on Twitter: @MHVDickson