MedPAC raises concerns about dual eligible demonstration

The Medicare Payment Advisory Commission on April 5 expressed concerns about a Center for Medicare and Medicaid Innovation demonstration project that will test financial models for states to better align financing and integrate primary, acute, behavioral health and long-term care services for dual Medicare and Medicaid enrollees. Several MedPAC commissioners raised questions about the project, including whether its design pushes it toward a waiver program instead of a demonstration; how states planned to enroll dual eligible beneficiaries in the demonstration and if it would limit their care choices; and how the demonstration's effectives would be evaluated.

The demonstration project, which CMMI estimates up to 2 million dual eligible beneficiaries could participate in, will test a capitated model and managed fee-for-service model to determine whether they save money while preserving or enhancing the quality of care for enrollees. MedPAC is expected to weigh in on the demonstration in its June report to Congress.