Managed Fee-for-Service Model

Using Health Homes to Integrate Care for Dually Eligible Individuals: Washington State’s Experiences

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.

New Opportunities to Test Innovative Models of Integrated Care for Dually Eligible Individuals

On April 24, 2019, CMS released a State Medicaid Director Letter that invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial Alignment models; (2) managed fee-for-service Financial Alignment models; and (3) state-specific models. 

Measurement, Monitoring, and Evaluation of the Financial Alignment Initiative for Medicare-Medicaid Enrollees Preliminary Findings from the Washington MFFS Demonstration

This report provides preliminary data for the first 18 months of Washington's managed fee-for-service demonstration. It includes a description of the demonstration model, preliminary findings on eligibility and enrollment in the demonstration, characteristics of the demonstration eligible population, selected early results on quality and utilization, and an estimate of Medicare savings.

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