Texas has partnered with CMS to test a new payment and integrated care delivery model for beneficiaries who are eligible for both Medicare and Medicaid.
The demonstration project is part of CMS' Financial Alignment Initiative, which aims to provide Medicare-Medicaid dual eligibles with a better care experience. The Texas project involves a capitated model, under which the state and CMS will contract with health plans or other qualified entities that will receive a prospective, blended payment to provide dual eligibles with coordinated care.
Texas already operates the STAR+PLUS program, which provides enhanced care coordination to Medicaid enrollees who are older than 65 or are disabled. Under the demonstration project with CMS, Medicare-Medicaid plans will cover Medicare benefits in addition to the benefits covered through STAR+PLUS.
The project will take place in six counties and will involve 168,000 eligible individuals, according to CMS. Enrollment will begin March 1, 2015.
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