Update on Capitated Duals Demonstration Enrollment

This week, our In Focus section reviews publicly available data on enrollment in financial and administrative alignment demonstrations for dually eligible beneficiaries (duals) in seven states currently serving duals in a capitated financial alignment model. These seven states – California, Illinois, Massachusetts, New York, Ohio, South Carolina, and Virginia – have begun either voluntary or passive enrollment of duals for fully integrated Medicaid and Medicare benefits under a three-way contract with the Centers for Medicare & Medicaid Services (CMS) and health plans, known as Medicare-Medicaid Plans (MMPs). Three additional states – Michigan, Rhode Island and Texas – also have established a demonstration with CMS but have not begun enrollment, as described further, below. As of February 2015, more than 300,000 duals are enrolled in a MMP, based on state-based and CMS reporting.

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