In March 2016 the U.S. Department of Health and Human Services released the Medicare-Medicaid Coordination Office (MMCO) Fiscal Year 2015 Report to Congress. The report includes an overview of the status of the Financial Alignment Initiative for dually eligible beneficiaries, administered by MMCO and currently underway across 13 states.
MACPAC’s authorizing statute requires it to review HHS reports to Congress and provide written comments to the Secretary and appropriate committees of Congress. In its July 11, 2016 comment letter, the Commission focuses on the Financial Alignment Initiative and expresses support for the Initiative’s broad goals to improve care for some of the poorest and sickest individuals covered by both Medicaid and Medicare. However, the Commission also voices concern with how little has been learned regarding effects on use of services, spending, the beneficiary experience, and other outcomes in the Initiative’s three years of operation. In addition, the Commission calls attention to apparently high rates of beneficiaries opting out and disenrolling from the Initiative and low rates of participation among states, observing that understanding the reasons that individuals who enter the program do not remain enrolled, and remedies that could be taken to reduce opt-out and disenrollment, will be critical to the design of future efforts. The Commission encourages CMS to provide more information on the Initiative’s payment policies and the effects of aligning the administrative aspects of Medicare and Medicaid. The Commission looks forward to reviewing future findings and will continue to monitor the effects of the Initiative.
For more information on the overall design of the Initiative and a comparison of key provisions of state approaches, please go to Financial Alignment Initiative for Beneficiaries Dually Eligible for Medicaid and Medicare.