Earlier this week, the National Association of Medicaid Directors (NAMD) said in a letter to the Centers for Medicare and Medicaid Services (CMS) that CMS should pay states a greater share of Medicare savings in duals demonstrations. A duals demonstration is one that seeks to improve on service delivery for populations that are dually eligible for Medicare and Medicaid, often with the goal of saving the system money by improving efficiency and reducing duplicative or wasteful spending. Currently, states participating in duals demonstrations receive a share of savings, but only after a certain threshold is achieved. The NAMD letter urges that states get "first dollar savings".
The letter also calls for changes to the enrollment process for duals, by allowing states to automatically enroll dually eligible individuals for Medicare benefits. States are currently allowed to automatically enroll beneficiaries for Medicaid benefits, with an opt-out option. The Medicaid Directors would like states to be able to use the same process for Medicare. Additionally, the letter urges CMS to make it easier to place people in duals-special needs plans (D-SNPs). States do not need to participate in a demonstration to use D-SNPs, which NAMD says is a way for states to better coordinate care for duals. The letter says that CMS can encourage this better care coordination by streamlining the process by which individuals are placed in D-SNPs.
Source: Inside Health Policy