MCOs Mull Managing Care for Duals in FFS Medicare Demo

January 7

With the aim of improving care for dual eligible individuals while promoting value-based care in fee-for-service Medicare, CMS last month introduced a new option for certain Medicaid managed care organizations to become Direct Contracting Entities (DCEs) that will coordinate care and share risk for duals who access their Medicare benefits through FFS. But some MCOs have questions about the design of the model, and one organization warns that the arrangement could have a detrimental impact on accountable care organization (ACOs) that have made significant investments in value-based care.

0 Comments

Radar on Medicare Advantage

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

2021 Outlook: COVID Vax, State Budget Issues Add to Medicaid MCOs’ Urgency to Address Disparities January 7, 2021

2021 Outlook: COVID Will Have Lasting Impact on MAO Investment Targets January 7, 2021