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December 12, 2017
Hot Topic
Managed care plans participating in CMS's pilot for beneficiaries dually eligible for Medicare and Medicaid are struggling to attract enough enrollees to make the program viable.
Today's AIS Health Datapoint
118 ... plans scored a 2.5 or lower on their overall CMS Star Ratings for 2018, compared to 130 last year. Three plans operated by Centers Plan for Healthy Living, LLC, a New York-based Medicare and Medicaid long-term care insurer, scored 2 overall.
AIS's Medicare and Medicaid Market Data: Enrollment, Premium Rates, Benefit Designs and Strategies of Medicare and Medicaid Plans

Quote of the Day
“The work requirement and to a lesser extent, drug testing and other items, all go with this idea of community involvement. The plans are fiduciaries of state and federal taxpayers, so if the state wishes to enforce a work requirement or other items, the plans will do their level best to make sure that that is as effective as possible….But if it is implemented in a way where the plans are required to make sure someone is working or to determine their work eligibility status, presumably it would be part of the administrative cost. That is expensive and is also not something the plans are designed to do.”
— Jeff Myers, president and CEO of Medicaid Health Plans of America, tells AIS Health about CMS’s plans to approve Medicaid Section 1115 waivers that promote work and volunteer activities.

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