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.