Report Examines Dual Eligibles DemonstrationImage Banner

Report Examines Dual Eligibles Demonstration

You are here

Report Examines Dual Eligibles Demonstration

September 5, 2012

The California HealthCare Foundation has released a report that evaluates a demonstration California participated in to transition 240,000 low-income seniors and individuals with disabilities into managed care from fee-for-service plans over the course of a year.

During the demonstration, participants encountered several difficulties, including confusion about the ability to maintain current providers, trouble understanding written materials received, lack of telephone counseling and support services and out-of-date contact information for beneficiaries. Some stakeholders noted that services to provide information, support and care coordination should have been offered earlier in the transition period, rather than after beneficiaries were enrolled in a plan.

The report is timely as the Centers for Medicare & Medicaid Services is currently moving forward with plans to transition 9 million dual eligibles (individuals eligible for both Medicare and Medicaid) into managed care plans. Some people, including Senator Jay Rockefeller (D-WV), have criticized CMS for moving too quickly with its plans, noting that proper implementation is vital to achieve the best possible health care outcomes.

As reported by ANCOR in July, Rockefeller wrote a letter to U.S. Department of Health and Human Services Secretary Kathleen Sebelius in July outlining his concerns with the program.