As it has signaled in its recent Advance Notice and Call Letter, the Centers for Medicare & Medicaid Services (CMS) is on the cusp of making a critical change to fix an inequity in the Medicare Advantage risk adjustment system that harms consumers with low incomes.
This is of particular interest to the Safety Net Health Plans that hold membership in the Association for Community Affiliated Plans (ACAP), most of which are dedicated to serving “full-benefit dual eligibles,” or people who are eligible for Medicare and all Medicaid services. Health plans serve full-benefit dual eligibles through either a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) or a Medicare-Medicaid Plan (MMP) in a Financial Alignment Demonstration—known more commonly as a “duals demonstration.”
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