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A longstanding barrier to coordinating care for Medicare-Medicaid enrollees has been the financial misalignment between Medicare and Medicaid. To begin to address this issue, CMS will test two models for States to better align the financing of these two programs and integrate primary, acute, behavioral health and long term services and supports for their Medicare-Medicaid enrollees. The Medicare-Medicaid Coordination Office and the Center for Medicare and Medicaid Innovation (Innovation Center) are collaborating on this initiative. These two models include:
  • Capitated Model: A State, CMS, and a health plan enter into a three-way contract, and the plan receives a prospective blended payment to provide comprehensive, coordinated care. 
  • Managed Fee-for-Service Model: A State and CMS enter into an agreement by which the State would be eligible to benefit from savings resulting from initiatives designed to improve quality and reduce costs for both Medicare and Medicaid.
States interested in pursuing the capitated and/or managed fee-for-service model were required to submit a proposal to CMS for a 30 day public comment period.  This site contains the public comments received by CMS in response to each State’s proposal, as well as a link to each proposal. All comments are organized by State. We are still in the process of redacting and posting comments on the remaining States, and they will be posted shortly.  If you have any concerns with your comment being public, please email:
 
 
 

 PUBLIC COMMENTS

 
  
  
  
  
  
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