« The Dual Agenda: November 5, 2015 Issue
State Highlights
The California Department of Health Care Services (DHCS) released the latest monthly enrollment dashboard for the Cal MediConnect dual demonstration project as of October 1. DHCS has also provided a breakdown of opt-outs by language, ethnicity and race. Information is provided for Los Angeles, Riverside, San Bernardino, San Diego, Santa Clara and Orange counties.
In other news, the SCAN Foundation released findings of a survey conducted on the Cal MediConnect program. Using campaign-style polling to understand the experience of people enrolling in and opting out of Cal MediConnect, the information produced is being delivered to state departments and health plans responsible for continuous quality improvement for the demonstration. Among the many findings, the one that rises to the top is fear of change as the biggest reason for not choosing coordinated care under Cal MediConnect. However, large majorities of enrollees are satisfied with the health services they are receiving in the program. The findings were presented at the foundation’s Long-Term Services and Support Summit.
A recent story on National Public Radio reported on Maryland’s experiment to pay hospitals using global budgeting to care for their patients, in place of the fee-for-service model. Instead of being paid per admission, hospitals get a set amount of money for the entire year for patient care, regardless of how many MRI tests, ER visits or hip replacements performed. At the end of the year, if there is money left over, the hospitals keep it. The state tested the approach in ten rural hospitals. The pilot worked, and in January 2014, global budgeting went statewide. Nearly two years into the five-year agreement, the Centers for Medicare and Medicaid Services say that hospitals are on track to hit targets of saving $330 million for Medicare and reducing hospital readmission rates while improving the overall health of residents.
Minnesota recently established a new health care financing task force to advise policymakers on strategies to increase access and improve the quality of care for Minnesotans, including options for sustainable health care financing, coverage, purchasing and delivery for all insurance affordability programs. Governor Dayton named 11 members to the task force, which includes strong representation from consumer health advocates and their allies.
A recent Modern Healthcare article (pay-gated content) highlights the struggles that the New York dual eligible demonstration project, called the Fully Integrated Duals Advantage (FIDA) program, is experiencing. The article suggests that the Centers for Medicare and Medicaid Services will engage providers to help the demonstration move forward and make any necessary mid-course corrections, though what those will be are not yet available.
The Virginia Department of Medical Assistance Services (DMAS) announced they will transition dual eligible individuals who opted-out of the dual eligible demonstration project, called the Commonwealth Coordinated Care (CCC) initiative, into mandatory managed care beginning July 1, 2016. Beginning July 1, 2017 the state will transition 70,000 additional individuals into mandatory Medicaid Managed Long-Term Services and Supports (MLTSS). The CCC program is slated to end December 2017, at which point DMAS will enroll these individuals into the MLTSS program on a phased-in basis.