Washington’s Managed FFS Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Washington is the first state to sign a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test a managed fee-for-service (FFS) financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, beginning on April 1, 2013. Washington’s managed FFS demonstration uses Medicaid health home services to coordinate care for high risk/high cost dual eligible beneficiaries with chronic conditions. This policy brief summarizes key aspects of the demonstration, including the target population; enrollment; care delivery model; benefits package; continuity of care provisions; financing; grievance and appeals system; disability accommodations; stakeholder engagement; oversight, reporting and quality measures; evaluation; governing authority and waivers; and implementation plans.

Report (.pdf)