Administration touts early success of Medicare/Medicaid coordination

By Julian Pecquet - 10/11/11 11:40 AM ET

Thirty-seven states and the District of Columbia are interested in testing new ways to coordinate care for people who are dually eligible for Medicare and Medicaid, the Obama administration announced Tuesday.

The federal healthcare law for the first time created an office tasked with improving care delivery for so-called "dual eligibles," who account for about 16 percent of Medicare enrollees but 27 percent of the program's spending. Oct. 1 was the deadline for states to indicate interest in a pilot program to test two new payment and service delivery models.

"Across the country States are moving forward and proposing new ways to better serve their Medicare-Medicaid enrollees," Melanie Bella, the director of the Medicare-Medicaid Coordination Office, wrote in a blog post.

"These innovative initiatives vary regionally and in their approach, ranging from using health homes that provide total care management to expanding existing programs to meet all of an individual's needs by incorporating behavioral health and long-term supports and services, as well as making current coordinated care models available to new populations, such as individuals with long-term care needs or those with serious and persistent mental illness."

"Over the next several months," she added, "we will be working closely with the States interested in further developing their approaches and will serve as a resource for any State interested in improving care for their Medicare-Medicaid enrollees. These models provide States and the Federal government with new flexibilities and pathways to make Medicare and Medicaid stronger."

Improving care coordination is one of the few improvements to the Medicare system that has broad bipartisan appeal.

Still, some lawmakers have urged the Centers for Medicare and Medicaid Services to move much more aggressively. Sen. Ron Wyden (D-Ore.), in particular, urged the deficit-cutting supercommittee to expedite a home care program for dual eligibles, saying he has been working on the issue for decades.

"Unless there's a commitment to move aggressively," Wyden told reporters after a hearing last month, "as sure as night follows day people will be sitting in hearing rooms like this in a few years having the same debate."