Model Medicare/Medicaid coordination program losing lots of money in Massachusetts
Two years ago Massachusetts launched a pilot program to provide better care for its poorest and sickest while simultaneously curbing costs. So far the results on the latter aim have been dismal.
In a business-page article published Aug. 3, the Boston Globe reports that the program—One Care, created to coordinate care of Bay Staters covered by both Medicare and Medicaid—has led to three insurers losing a combined $54 million.
That’s notable, the Globe points out, because One Care was the first of its kind in the U.S. and 11 other states have followed its example so far.
To date, the three nonprofit insurers participating in the pilot program have enrolled fewer than 18,000 people.
One, Worcester-based Fallon Health, has taken a $13 million hit and announced its exit from the program, along with 45 layoffs and other recovery measures, according to the Globe.
Meanwhile, Commonwealth Care Alliance, headquartered in Boston, has lost more than $40 million—but remains mission-driven and isn’t giving up yet.
“It’s the right model of care, I think we all agree to that,” Lois Simon, the group’s president, told the Globe. “We’ve got some fixing to do. We have to get this right for this population.”
The newspaper said federal officials declined to comment on how those other 11 states are making out with their versions. Click here to read the full article.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.