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. But beneficiary participation has been lower than anticipated. Only about 29 percent of eligible individuals enrolled in MMPs in 2017.
MACPAC contracted with Mathematica Policy Research to better understand the factors that drive beneficiary enrollment. Mathematica’s study finds that higher enrollment in the MMPs is strongly related to three primary factors: passive enrollment; aligning FAI demonstrations with managed long-term services and supports; and positive relationships between beneficiaries and care coordinators.
Read the contractor report, The Complex Art of Making It Simple: Factors Affecting Enrollment in Integrated Care Demonstrations for Dually Eligible Beneficiaries, and the report appendices here.