Twenty-six states have submitted proposals for a federal demonstration program to integrate Medicare and Medicaid services for dually eligible beneficiaries, or people enrolled in both programs. The Kaiser Family Foundation (KFF) recently released a report comparing states proposals in the areas of target population, implementation date, enrollment, financing, benefits, beneficiary protections, stakeholder engagement and demonstration evaluation.
Most states are proposing to enroll all dually eligible beneficiaries within a specific geographic area into these demonstrations. A few states have proposed limiting the number of duals enrolled by either age or types of services used. Most states will also passively enroll their target populations into the demonstrations and then give beneficiaries the option of disenrolling later. All state proposals aim to improve care coordination and quality for dually eligible beneficiaries and reduce state expenditures in both Medicare and Medicaid. While two states initially planned to begin implementation sometime this year, demonstrations will most likely launch in 2013 or 2014. So far, Massachusetts and Washington have released a Memorandum of Understanding with the Centers for Medicare & Medicaid Services (CMS).