To provide more integrated, coordinated care for its residents who are dually eligible for Medicare and Medicaid, Washington State is operating a demonstration under the Financial Alignment Initiative offered by the Centers for Medicare & Medicaid Services. This case study describes: (1) the demonstration’s structure; (2) results achieved to date; and (3) insights on the demonstration’s implementation from the state and other stakeholders.
This brief describes several administrative changes that state Medicaid programs can make to: (1) support integration efforts; (2) improve beneficiaries’ experience of care; (3) decrease beneficiary out-of-pocket costs; and (4) reduce provider burden. Taking the steps described in this brief may help states build stronger, more effective integrated care programs and better position them to implement larger-scale integration efforts for their dually eligible populations.
This brief describes value-based payment approaches currently used in select states and managed care plans, including the quality and performance measures they use, benchmarks or targets for those measures, and incentives that reward facilities. It also describes approaches to designing, administering, and evaluating state programs.
Release of the 2020 Final Rate Announcement of MA Capitation Rates and MA and Part D Payment Policies, including the CY 2020 Call Letter
Release of the CY 2020 Plan Creation Module, Plan Benefit Package (PBP), and Bid Pricing Tool (BPT) software in HPMS.
Deadline for MA, MA-PD and PDP plans to notify CMS of their intention to non-renew a county (ies) or region(s) for individuals, but continue the county (ies) or region(s) for “800 series” EGWP members, to convert to offering employer-only contracts, or to
Release of final CY 2020 ANOC/EOC, LIS rider, Part D EOB, formularies, transition notice, provider directory, and pharmacy directory models for all organizations.