Saturday, December 3, 2011

More information on Michigan Dual Eligibles workgroups

The "Integrating care for dual eligibles in Michigan" Website has more information on the four workgroups that are making recommendations to the state. Rosters for each group are available along with meeting times and dates, agendas, summaries of meetings, and additional documents and information.

I have been participating in the Workgroup on "Education, Outreach, and Enrollee Protections". It is hard to tell if  the workgroups will have much of an impact on the state. The Michigan Department of Community Health has set limits on the topics that are covered by the workgroups, placing the most controversial aspects of the state's plan for dual eligibles out of bounds for discussion: whether Medicaid managed-care plans are the best entities to manage and finance services for dual eligibles, whether allowing consumers to opt-in rather than opt-out of the plan is a better idea, and whether the plan as it has so far been described by the state is worth the partial destruction of the Community Mental Health system. 

Other metaphorical elephants in the room: the issue of local control and access that is one feature of the Community Mental Health system that would likely be lost; citizen representation of people directly served by and affected by the system of care that exists in the CMH system but is lacking in the dual eligibles plan; a lack of transparency and access to Medicaid managed-care plans that appear to be the most likely entities to manage services for dual eligibles; managing costs of health plans that pay exorbitant executive salaries; the effects of privatizing mental health services for dual eligibles - an idea that was soundly defeated in the state more than a decade ago; rivalries between groups affected by the plan; different federal mandates for different groups of beneficiaries; and expecting to save money by combining several under-funded groups and transferring funds from a CMH system that has been successful at holding down Medicaid costs to another system that has little experience serving the populations served by CMH.

At the end of each Workgroup meeting there is a time for public comment. The Workgroups meet again on December 13 and 15 in Lansing. After that, the state will put together its plan and release it for public comment. This will be the first time that we see in detail what the state intends to submit to the Centers for Medicare and Medicaid for integrating care of dual eligibles and your comments on the plan will be important.

For background on the dual eligibles plan, see the DD News blog here.

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