CMS-State Dual-Eligible Initiatives: What’s Ahead for Health Plans and Providers?

After an intense period of submissions and scrutiny, CMS has begun approving state proposals for huge new integrated care initiatives for Medicare-Medicaid dual eligibles. Massachusetts received the first go-ahead Aug. 23, and numerous other states among the 26 submitting proposals to the CMS “duals office” may be close behind. However, startup dates are being delayed, and there is still a host of uncertainties about such aspects as capitation rates, what and how providers will be paid, “passive enrollment,” the counseling of beneficiaries and more.

Get a timely, reliable update from experts on what happened and will come next, and find out what your organization and partners need to do now to prepare for the fabulous opportunities ahead.

What began in July 2011 as the first major program of the CMS Federal Coordinated Health Care Office is now a giant reality. That duals office has started approving state initiatives to furnish integrated care to Medicare-Medicaid dual eligibles as a way to improve outcomes and reduce costs, with the initial programs to begin next spring. But there are lots of strings attached to the approvals, and key information such as capitation rates is not yet known, as health plans and their partners gear up for this quantum change in how care is delivered to large numbers of the nation’s most vulnerable citizens.

While plans in many states, for instance, will be able to use passive enrollment so that beneficiaries must opt out if they don’t wish to participate in the initiatives, plans will not be able to “lock in” those beneficiaries for any length of time. And state initiatives will have to include a prominent role for duals in the governance structure.
 
Join us on Oct. 18 and hear Peter Harbage of Harbage Consulting, California’s consultant for its dual-eligibles initiative, Gregory Scott of Deloitte and Valerie Wilbur of the SNP Alliance examine the most recent developments on the state dual initiatives, what is likely to happen next at the federal and state levels, and what steps plans and providers should take now to get ready for the terrific opportunities ahead. You’ll get reliable strategic information on key questions such as:

Following the 60 minutes of expert presentations, a concluding 30-minute Q&A session will provide answers to your questions on what the decisions made by CMS and states so far mean for health plans and their partners in dual initiatives. Sign up today!

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