Enrollment in Duals Programs Increases 14%, New AIS Database Finds

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Enrollment in programs designed to coordinate reimbursement for Medicare-Medicaid dual eligibles reached 2.2 million in April, according to the editors of Atlantic Information Services’s new online Medicare-Medicaid Dual Eligibles Database.

Enrollment in programs designed to coordinate reimbursement for Medicare-Medicaid dual eligibles reached 2.2 million in April, according to the editors of Atlantic Information Services, Inc.’s (AIS) new Medicare-Medicaid Dual Eligibles Database, an online subscription resource that tracks all programs and plans serving the dual-eligible community. This is a 14% increase since the Medicare-Medicaid Dual Eligibles Database began tracking initiatives in January, but only covers about a quarter of dual eligibles nationwide.

“Monthly tracking of enrollment numbers is imperative to understanding what works to efficiently cover this population,” says AIS Database Director Susan Namovicz-Peat. “It’s complicated, because some programs require members to disenroll from their current plan, and then there are passive enrollment procedures and opt-out rates — duals plans contend with a lot of volatility in their membership.”

There are an estimated 9 million Medicare-Medicaid dual eligibles in the United States, in a variety of state and federal programs, accounting for more than $300 billion in annual health care spending. Medicare-Medicaid Dual Eligibles Database counts 18 programs with enrollment so far — including:

  • Centers Medicare & Medicaid Services (CMS) Dual Eligible Special Needs Plans (D-SNPs)
  • Program of All-inclusive Care for the Elderly (PACE) plans
  • Duals Demonstration Projects in 11 states
  • Five unique state-level initiatives in four states

In addition, the Medicare-Medicaid Dual Eligibles Database is tracking one CMS demo about to begin enrollment and four more pending CMS approval.

Each program is taking a different approach to meeting the challenges represented by this fragile and costly population — one state demo has already been cancelled due to lack of carrier participation. Medicare-Medicaid Dual Eligibles Database editors report 546 plans currently serving 2,244,756 enrollees, and another 32 plans just beginning to enroll.

More than just a convenient, current and comprehensive online database, the Medicare-Medicaid Dual Eligibles Database boasts original news coverage by experienced AIS reporters with a thorough understanding of the stakes involved for health plans seeking to enter this market. Recent coverage includes detailed reports from AIS’s April 16 virtual conference on dual-eligible initiatives and a summary of a recent report examining why duals have worse outcomes than non-duals on star-rating measures. For more information and to use a free demo of Medicare-Medicaid Dual Eligibles Database, visit http://aishealthdata.com/dual.

About Atlantic Information Services
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://AISHealth.com.

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Susan Namovicz-Peat, Director, Directories and Databases Division
Atlantic Information Services
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