Arnold Ventures’ Complex Care team took action to help protect the more than 12 million people dually eligible for Medicare and Medicaid.
In a letter to the Centers for Medicare and Medicaid Services (CMS) sent on Feb. 13, AV encouraged the agency’s effort to improve Medicare Advantage (MA), the privately run arm of the Medicare program.
AV’s work to date on the MA program has focused on increasing the program’s financial sustainability while ensuring that it has greater ability to coordinate and organize delivery systems to improve care. That’s especially important for the dual-eligible population, which faces poor health outcomes despite accounting for high costs.
The comment letter from AV was sent in response to a proposed federal rule published in late December. The letter expressed support for CMS’ efforts to curb the use of models that target the dual-eligible population without offering the benefits of integration between Medicare and Medicaid. It specifically noted the problem of regulatory loopholes that allow these “look-alike” plans to persist.
“Ensuring that all dual-eligible individuals have access to a model that integrates their Medicare and Medicaid coverage has potential to improve care and outcomes for this population, and non-integrated models that target dual-eligible individuals undermine this effort,” the letter says.
Read the entire comment letter below: