Dual-Elligible Demonstration Stakeholder Update

This week there was stakeholder meeting for Colorado's "Demonstration to Integrate Care for Dual Eligible Individuals."  Essentially, this project aims to steam-line care and billing for individuals who receive both Medicaid and Medicare.  Since many individuals with intellectual and/or developmental disabilities (I/DD) are dual eligible, this is an important project for Innovations to follow.  Click here to read the complete proposal that the State of Colorado Department of Healthcare Policy and Financing (HCPF) submitted to the Centers for Medicare and Medicaid (CMS).

At this point, HCPF is negotiating with CMS to ensure that Colorado benefits from any savings from this program.  Once a deal is reached, and a Memorandum of Understanding is finalized, the State will move forward with implementation of the program.  HCPF expects that the first enrollees of the program will begin receiving Demonstration services as of June 1st, 2013.  There is an Advisory Group for this project that meets regularly.  Click here for the minutes of that group's latest meeting.

Enrollment in this Demonstration is done passively, where an individual who is Dual Eligible will receive a letter asking them if they want to opt out of the demonstration.  If the individual chooses not to opt out or does nothing, then they will be enrolled in the demonstration.  At this point, we think that the Demonstration will benefit individuals, as it will help their physicians coordinate care.  Initially, we were concerned about provider enrollment, but HCPF has made provider enrollment a priority, and have ensured that an individual will not lose their primary care physician by participating in this demonstration.  We will continue to follow the implementation of this project and will post more details as they become available.