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State Demonstration Proposals to Integrate Care and Align Financing and/or Administration for Dual Eligible Beneficiaries « » The Henry J. Kaiser Family Foundation

State Demonstration Proposals to Integrate Care and Align Financing and/or Administration for Dual Eligible Beneficiaries

 

 

8426-06 Figure 1

This map shows the current status of the state demonstration proposals to integrate care and align financing and/or administration for beneficiaries eligible for both Medicare and Medicaid. Over 9.6 million seniors and younger people with significant disabilities are dually eligible for both programs, and as many as 2 million of them may be included in the demonstrations. Dual eligible beneficiaries are among the poorest and sickest beneficiaries covered by either program and consequently account for a disproportionate share of spending in both programs.

A number of states are working with the Centers for Medicare and Medicaid Services (CMS) to develop proposals to test capitated and/or managed-fee-for service models to integrate care and align financing for dual eligible beneficiaries, based on new demonstration authority in the Affordable Care Act. CMS is presently reviewing the states’ proposals to determine which will be implemented. Enrollment in the first demonstration became effective in July 2013, with others expected to follow in late 2013 and in early 2014.

For more information see Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS.