ACAP Medicare-Medicaid Plans Policy Priorities

ACAP’s MMP Policy Priorities
November 2016


1. To create sustainability and certainty of integrated care options for dual eligibles, Congress should make Medicare-Medicaid Plans (MMPs) a permanent program.
Medicare-Medicaid Plans utilize a new, person-centered model of care to better integrate Medicare and Medicaid benefits for individuals enrolled in both programs. By making the program permanent, Congress will eliminate uncertainty for MMPs, states, and enrollees about the future of the program. Making MMPs permanent will allow the program to remain an option for states to use to integrate Medicaid services for dual eligibles.

2. To improve enrollment and retention in the program, CMS or Congress should enact the following changes:
a. Allow MMPs to directly market and enroll eligible members.
b. Give MMPs greater flexibility to help with the eligibility and enrollment process.
c. Streamline and improve the enrollment information that is sent to eligible beneficiaries from Medicaid agencies.
d. Align CMS and state enrollment dates and marketing review.
e. Allow seamless conversion into MMPs for dual-eligible beneficiaries that age into Medicare and for dual-eligible beneficiaries under age 65 that gain Medicare eligibility after the two-year waiting period.
f. Continue the passive enrollment process into MMPs.
g. Include a lock-in period (e.g., 3 to 9 months) after enrollment to give plans time to find and assess enrollees and for enrollees to realize the value of the program.

3. To improve sustainability of MMPs, CMS or Congress should enact the following care coordination, quality reporting, and payment system changes:
a. Allow plans to have more flexibility around care coordination requirements.
b. Maintain a reasonable number of quality measures by aligning state and federal quality measures and by removing measures when new ones are added to fill measurement gaps.
c. Revise the risk-adjustment model to better account for costs associated with mental health conditions and social determinants of health.
d. Determine realistic savings percentages for MMPs, particularly as the program continues beyond the initial three years of the demonstration.

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