CMS Shares Evaluation of Medicare-Medicaid Financial Alignment Efforts
In 2011 the Centers for Medicare & Medicaid Services launched a “Medicare-Medicaid Financial Alignment Initiative” that seeks “…to provide Medicare-Medicaid enrollees with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs.”
How is that initiative working so far? CMS recently released three reports that evaluate different aspects of the program. Those reports are:
- “Early Findings on Care Coordination in Capitated Medicare-Medicaid Plans under the Financial Alignment Initiative”
- “Beneficiary Experience: Early Findings from Focus Groups with Enrollees Participating in the Financial Alignment Initiative”
- “Issue Brief: Special Populations Enrolled in Demonstrations under the Financial Alignment Initiative”
Pennsylvania’s private safety-net hospitals serve especially large numbers of dually eligible Medicare and Medicaid beneficiaries, so such programs are always of special interest to them.
In addition to viewing the reports, go here to learn more about the Medicare-Medicaid Financial Alignment Initiative.
The process of determining Medicaid eligibility in Pennsylvania either begins or works its way through the state’s county assistance offices.
Among those steps are ensuring that only providers registered with the state’s Medicaid program can prescribe opioids and fill opioid prescriptions for Medicaid patients; monitoring the opioid-prescribing practices of participating Medicaid providers and taking actions when those practices are inappropriate; introducing new opioid prescribing guidelines; improving access to naloxone to fight opioid overdoses; expanding drug treatment programs; and more.
The Pennsylvania Health Law Project has issued a statement detailing its perspective on the recently proposed American Health Care Act, which would both repeal and replace the Affordable Care Act of 2010.
Among the issues on the agenda of the Medicaid and CHIP Payment and Access Commission were:
The reason: for the second time, companies that lost a public bidding process protested the state’s choices. The first time, the state threw out all the bids and started over again. This time the state says it needs more time to deal with the protests, negotiate new contracts, and get the new contractors up and running.