In an effort to cut confusion and cut costs, Governor Terry McAuliffe announced the merger of Medicare and Medicaid benefits for Virginians enrolled in both programs Thursday. The move eliminates two sets of often misaligned rules, and launches the new endeavor in one new program.
The new initiative is now known as Commonwealth Coordinated Care (CCC), a program that will cover an estimated 78,000 Virginians. Gov. McAuliffe said the goal is to eliminate complicated rules, and to help patients request the care they need.
"Nationwide, individuals who are dually eligible for Medicare and Medicaid typically have the highest and most complex medical needs but are often underserved," McAuliffe said at a news conference Thursday. "CCC will blend all of the benefits currently provided under Medicare and Medicaid into one plan."
Letters are now being sent to all Virginians who are eligible for the plan. The letters provide information on how to enroll, as well as contact information for representatives charged with answering questions.
Highlights of CCC include a care manager for each patient, a feature Secretary of Health and Human Resources, Dr. William A. Hazel, Jr. said goes beyond current benefits for Medicaid and Medicare.
"[A care manager] will complete a comprehensive evaluation to understand the enrollee's situation and work directly with the enrollee to develop a plan of care that is tailored to their needs and preferences," Hazel said.
Republicans largely dismissed the announcement as a plan that was already in the works for three years. Advocates for senior citizens also expressed concerns that patients may throw out the enrollment letters by mistake, or not understand the changes.
"Even if the letter is thrown out, people who receive certain medications from Medicaid and Medicare will continue to receive the same medications under the new system," said Cindi Jones, director of Virginia's Department of Medical Assistance Services in a phone interview Thursday. "And if you don't like the new merged plan, you have the right to opt out, and go back to how things were before."
When eligible patients enroll, there will be three healthcare providers to choose from – Anthem Healthkeepers, Humana, and Virginia Premier. The choice will largely depend on which company best covers each patient's needs.
At present, CCC is set to run four years with the possibility of a future extension. Gov. McAuliffe said CCC would save the Commonwealth an estimated $126 million through 2016. Virginia is now one of three states merging Medicare and Medicaid benefits.
Coverage for people who respond to the enrollment letters will begin as early as April 2014.
Eligible patients who do not respond to the letters will automatically be enrolled, with coverage beginning in August 2014. A computer algorithm will select which of the three healthcare providers best meets the needs of those who do not respond.
More information can be found by visiting the Commonwealth Coordinated Care website.
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