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Medicare/Medicaid dual eligible reform plan update

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On Friday, the Medicaid Council passed the recommendations of the Complex Care Subcommittee on DSS’s application for an integrated care demonstration program for people eligible for both Medicaid and Medicare. The committee recommended that the Council endorse DSS’ application with the condition that providers be rewarded based on performance on quality measures; the amount they receive may be reduced if they do not also produce savings for their enrollees by an amount or percentage to be determined. The rewards are in addition DSS opposed the recommendation arguing that rewarding only providers who both generate savings and reach performance standards is the best way to ensure the program generates savings. The recommendation passed unanimously with two abstentions. Public comments on the application are being accepted until May 24th.

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