« The Dual Agenda: September 3, 2015 Issue

State Highlights


The California Department of Health Care Services (DHCS) submitted a non-binding letter of intent to the Centers for Medicare and Medicaid Service (CMS) indicating the state’s interest in considering an extension of the Coordinated Care Initiative (CCI). The letter is in response to a CMS memo that announced an opportunity for states to extend existing dual demonstration projects by two years.

In other news, California DHCS released new data on Health Risk Assessment (HRA) completion rates in the Cal MediConnect program. The data reported is from the period April 2014 to March 2015. According to the data, 89 percent of HRAs were completed within 90 days of enrollment.

New York

A recent article in Capital New York highlights the enrollment dilemmas in New York’s Fully Integrated Duals Advantage (FIDA) program. FIDA has about 7,700 people enrolled, while 54,287 others have opted out of the program. The article points out several factors that are contributing to the high opt-out rates: beneficiaries are wary of a new program and afraid to change care delivery they’ve worked hard to patch together; providers are either unaware of the program or unwilling to be part of new networks for fear of additional administrative burdens and requirements; and, with New York undergoing several other programmatic changes in its Medicaid program, it’s confusing to understand them all.


The Ohio Department of Medicaid (ODM) released the state’s first Medicaid score card for five managed care plans: Buckeye; CareSource; Molina; Paramount Advantage and United Healthcare. All of the plans, except Paramount, also are participating plans in the MyCare Ohio dual eligible demonstration project. The report card shows how the five plans compare to one another in five categories: access to care, doctors’ communication and service, keeping kids healthy, helping those with chronic illness and women’s health care.

Rhode Island

Community Catalyst, with input from our Rhode Island state partners, published a fact sheet outlining key provisions of the Memorandum of Understanding between the Centers for Medicare and Medicaid Services and the state of Rhode Island for a dual eligible demonstration project. The fact sheet covers areas that advocates will be focusing on as details are worked out for the three-way contract to be concluded between CMS, the state and the participating plan, Neighborhood Health Plan of Rhode Island. A Community Catalyst blog post puts in perspective the opportunity this latest demonstration can provide for course corrections, based on the experiences in other states’ demonstrations. The opportunity the demonstration presents to provide better coordinated and integrated care for Rhode Island’s dually eligible population was the subject of an August 17 op-ed in The Providence Journal co-authored by Voices for Better Health project partner Maureen Maigret, consultant for the Senior Agenda Coalition, and the project’s two Rhode Island geriatric provider advocates, Dr. Richard Besdine and Martha Watson.


The Virginia Department of Medical Assistance Services recently updated its enrollment dashboard for the Commonwealth Coordinated Care program, the state’s dual eligible demonstration project. As of August 8, 27,254 individuals are enrolled in the program. By the end of October, the state expects an additional 1,946 people to be enrolled in the demonstration.  Forty-three percent – 28,580 beneficiaries – of the 66,466 eligible beneficiaries statewide have opted out of the demonstration. According to the dashboard, beneficiaries who opted out in July either preferred traditional Medicaid (47 percent) or wanted to stay with a provider who was not participating in the demonstration (26 percent).

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