Dually eligible beneficiaries began enrolling in integrated Medicare-Medicaid plans (MMPs) under the Financial Alignment Initiative (FAI) in calendar year 2013. Under the FAI, the Centers for Medicare & Medicaid Services (CMS) and 10 participating states contracted with MMPs under capitated arrangements to coordinate Medicare and Medicaid benefits. Beneficiary participation has been lower than anticipated. Only about 29 percent of eligible individuals enrolled in MMPs in 2017.
To better understand the low enrollment, MACPAC contracted with Mathematica Policy Research to examine program elements, state policies, and MMP characteristics, and strategies to identify factors associated with enrollment. The analysis included interviews with state Medicaid officials in the 10 states and representatives from 15 MMPs. Appendices explain the study data and methods including:
- a temporal analysis to determine whether a major change in state policy or strategy was followed by a marked change in enrollment (Appendix A),
- the different populations included in the FAI capitated model demonstrations (Appendix B),
- enrollment growth graphs and timelines for each state (Appendix C),
- D-SNP presence in capitated model demonstration states (Appendix D),
- state enrollment policies and processes (Appendix E),
- state marketing and outreach policies (Appendix F),
- state experience with managed long-term services and supports prior to implementation of the FAI (Appendix G), and
- MMP characteristics and prior managed care experience (Appendix H).
To read the contractor report, click here. For more information on the FAI, visit the Financial Alignment Initiative subtopic page.