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A dry notice buried on a government website has been triggering alarm among health insurers and lobbyists ever since the news was posted late Tuesday afternoon.
The source of anxiety: an announcement from the Centers for Medicare and Medicaid Services (CMS) that a pilot program designed to improve the health and satisfaction of sick patients and save taxpayers money had failed.
Starting in July, 68,000 Medicare beneficiaries in five states and the District of Columbia will be dropped from care-coordination programs treating their diabetes and congestive heart failure. In addition, five health insurance companies will lose out on lucrative government contracts, and the industry could be deprived of a new area for revenue growth.
The announcement was atypically low-key. CMS did not issue a press release acknowledging the end of the program’s first phase. The agency advised congressional staff Tuesday afternoon, but the first public statement about the decision to close out the program came in the form of a mass e-mail from the agency’s capital markets adviser, which goes primarily to Wall Street analysts.
CMS downplayed the significance of the way it made its findings on the program public.
“We provided this information to the five organizations affected by the program yesterday afternoon and followed with a notice to the Hill just after 4 p.m.,” a spokesman wrote in an e-mail. “There was no press release because the program is not ending. It is continuing until the end of phase one and the programs will be working with their enrollees to help them continue to get their Medicare coverage.”
But the participating companies say they were caught flat-footed when word found its way to their trade group, DMAA: The Care Continuum Alliance. Participating companies include health industry giants Aetna, Humana and McKesson Health. (DMAA refers to its former name, the Disease Management Association of America.) [Editors note: McKesson Health Solutions is no longer participating in the Medicare care coordination pilot project, having withdrawn from the program in May 2007.] “We had no advance notice,” DMAA President and CEO Tracey Moorhead said.
CMS will not make its final determination about whether to launch the second phase of the program until it receives a report for its outside auditors. But the negative assessment this week does not bode well for the program’s future prospects.
The under-the-radar nature of CMS’s decision contrasts with promises of transparency from acting Administrator Kerry Weems, who said when he took office last September that he would conduct “business in daylight” and stop “cocktail-hour press release[s].”
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