Fifteen states have proposed plans to better integrate care for people enrolled in both Medicare and Medicare, according to a report by the Kaiser Commission on Medicaid and the Uninsured.
CMS awarded $1 million to each of the 15 states in April to develop these delivery and payment models for dual-eligible beneficiaries, which total nearly 9 million people. Medicare is the primary payor for these people, and Medicaid provides assistance with Medicare premiums and pays for services not covered by Medicare.
The states included in the report are California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington and Wisconsin. Concepts in these proposals are expected to change as CMS determines which proposals will be implemented.
The following are some of the proposed service delivery models:
• Tennessee and Wisconsin proposed to contract with risk-based private managed care organizations.
• California proposed to utilize county managed care plans, although suggested other models such accountable care organizations.
• Vermont proposed to have the state Medicaid agency become the managed care organization for dual-eligible beneficiaries.
• Numerous states proposed options available under the healthcare reform law, such as ACOs, integrated care networks and primary care case management.
Read the entire report on proposed models for dual eligible people (pdf).
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CMS awarded $1 million to each of the 15 states in April to develop these delivery and payment models for dual-eligible beneficiaries, which total nearly 9 million people. Medicare is the primary payor for these people, and Medicaid provides assistance with Medicare premiums and pays for services not covered by Medicare.
The states included in the report are California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington and Wisconsin. Concepts in these proposals are expected to change as CMS determines which proposals will be implemented.
The following are some of the proposed service delivery models:
• Tennessee and Wisconsin proposed to contract with risk-based private managed care organizations.
• California proposed to utilize county managed care plans, although suggested other models such accountable care organizations.
• Vermont proposed to have the state Medicaid agency become the managed care organization for dual-eligible beneficiaries.
• Numerous states proposed options available under the healthcare reform law, such as ACOs, integrated care networks and primary care case management.
Read the entire report on proposed models for dual eligible people (pdf).
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