Dive Brief:
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Five of 22 health insurers have now left the Fully Integrated Duals Advantage program (FIDA), a Medicaid reform program that sought to enroll New York's population that is dually eligible for both Medicare and Medicaid.
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The state's 700,000 dual-eligibles cause a disproportionate amount of New York's Medicaid spending, with 15% accounting for 45% of spending in 2011, Crain's New York Business reports. However, as of this month, only 7,540 dual-eligibles have enrolled in the program.
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Following a lackluster first year, the five plans opting out of FIDA for 2016 are ArchCare, EmblemHealth, Integra, Montefiore HMO and Empire BlueCross BlueShield HealthPlus.
Dive Insight:
While the state has admitted some mistakes, it says it remains committed to the program and lays some blame on insurers for failing to commit to the program and effectively market it.
The initiative sought to better coordinate Medicaid and Medicare benefits for enrollees in order to effect better care at lower costs. However, the program failed to catch on, as patients and providers alike were provided little education, physicians noted "burdensome rules," and patients worried they would lose access to their current providers and drug coverage.
The benefits of FIDA include zero premiums, deductibles or co-pays, and the provision of a care manager.
New York is reportedly asking the federal government to continue the program through 2019 and considering participation incentives for physicians and patients.