« The Dual Agenda: July 9, 2015 Issue

Noteworthy News

Colorado Makes Progress on Behavioral Health Integration Plans

The state of Colorado announced in late June that six insurers and the state’s Medicaid program have adopted reforms seeking to better integrate behavioral and physical health care, also a key area of concern in the dual eligible demonstration projects. The approaches developed by each of the plans vary in details and are shaped to meet the needs of different consumer populations, but all reforms meet the requirements of Colorado’s State Innovation Model, an effort to integrate behavioral and physical health and develop payment structures that support that goal.

Care Delivery Transformation in California: Aligning Opportunities With Capacity

As reported in the Huffington Post, The SCAN Foundation released a new report that highlights the breadth and depth of ACA-created care models that have been adopted or are being seriously explored in order to give Californians access to better, coordinated, and hence more person-centered care. New care models California has implemented or is exploring include Accountable Care Organizations, Community-Based Care Transitions, Fully Integrated Dual Eligible Special Needs Plans, and future Medi-Cal Health Homes – all of which are philosophically anchored in coordinated care through the eyes of the person and their individualized needs.

In his Huffington Post blog, SCAN Foundation President Bruce A. Chernoff, MD, writes, “Testing these new models is truly uncharted territory and may be uncomfortable at times for all parties involved. It takes time to learn and evolve major systems of care in order to reach the goals of improved population health, better care, and lower costs. Currently, 35 counties are testing at least one, and in many cases several new care delivery models… The Foundation has believed that actively engaging local stakeholders championing the needs of their communities is critical in shaping the delivery system of the future.”

Slow Pace of FIDA Enrollment Reported in NY Business Newsletter

An article in Crain’s New York Business “Health Pulse” daily newsletter captures the health care industry’s concerns about enrollment and lack of provider participation in the Fully Integrated Duals Advantage (FIDA) program, New York’s dual eligible demonstration project. Plans in New York feel that FIDA enrollment has fallen far below expectations, with only 4,407 members as of June 2, while 47,702  have opted out. At the same time, the article notes that state has not yet convinced providers of the value of the demonstration.

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