SC one of 15 states to receive CMS contract

South Carolina is one of 15 states across the county selected to design new ways to meet the often complex and costly medical needs of the nation’s lowest-income and chronically ill citizens, the Centers for Medicare & Medicaid Services (CMS) has announced.   

To address some of these issues, CMS is looking to these 15 states to develop creative ways to provide more efficient and less confusing health care delivery for so-called “dual-eligible” beneficiaries.  Funding for this project was provided by the Affordable Care Act.

There are around nine million dual eligible Medicare and Medicaid recipients.  While that represents a small percentage of the approximately 100 million people enrolled in the two programs they account for a disproportionate amount of spending or about $300 billion a year across both programs. For example, dual eligible beneficiaries account for 16 percent of Medicare enrollees but 27 percent of Medicare spending; in the Medicaid program, individuals dually enrolled make up 15 percent of the program but account for 39 percent of costs.

Under the State Demonstrations to Integrate Care for Dual Eligible Individuals, selected states will be awarded up to $1 million ¬¬to design strategies for implementing person-centered models that fully coordinate primary, acute, behavioral and long-term supports and services for dual eligible individuals.  After federal review of the proposals, CMS will work with states to implement the plans that hold the most promise.

In addition to the states receiving these awards, CMS will also be working closely with all states that request assistance in improving care coordination for dual eligible individuals.

The states selected include: California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington and Wisconsin.

States will work with beneficiaries, their families and other stakeholders to develop their demonstration proposals.   

Additional information can be found at:

04-14-2011 12:00 (EDT)