Demonstration

This report uses a variety of data sources to analyze the impact of the Washington Health Homes demonstration. The Washington Health Homes MFFS demonstration leverages health homes to integrate care for high-cost, high-risk full-benefit Medicare-Medicaid enrollees. This report addresses the demonstration’s approach to integrating the Medicare and Medicaid programs; providing care coordination to enrollees; enrolling beneficiaries into the demonstration; and engaging stakeholders.

This report summarizes the Medicare Parts A & B actuarial savings analysis of the Washington managed fee-for-service (MFFS) demonstration for 2015 and 2016. The Washington Health Home MFFS demonstration aims to improve service quality and integration while reducing costs of care for high-risk, high-cost dually eligible beneficiaries. For 2015, Washington demonstrated a final gross Medicare savings of $30 million. The preliminary gross Medicare savings for 2016 are $42 million.

The Center for Health Care Strategies (CHCS) published their report, “ACAP Medicare-Medicaid Plans and the Financial Alignment Demonstrations: Innovations and Lessons”, that was prepared for the Association for Community Affiliated Plans (ACAP). The report examines the experiences of 14 ACAP plans that are participating in capitated model demonstrations for the Centers for Medicare & Medicaid (CMS) Financial Alignment Initiative.

Justice in Aging published an issue brief that offers an analysis of the findings from the evaluation of the Financial Alignment Initiative (FAI), commonly known as the dual eligible demonstration. Research Triangle Institute was contracted by the Centers for Medicare and Medicaid Services (CMS) to conduct this evaluation, which focused on the first six months of operation of the demonstration in each of the seven states where it was rolled out.

The Centers for Medicare & Medicaid Services (CMS) began the Financial Alignment Demonstration in 2013 to improve care coordination. GAO was asked to examine care coordination under this demonstration. On January 19, The Government Accountability Office publicly released a report with their recommendations for CMS. GAO recommends that CMS develop new measures and align the current measures to improve oversight of care coordination.