Financial Alignment Initiative

This brief looks at states who operate Medicare-Medicaid integrated care models based on demonstrations under the federal Financial Alignment Initiative (FAI) or through Dual Eligible Special Needs Plans (D-SNPs) that are aligned with Medicaid managed care plans. It explores factors that contributed to state investment and successful program implementation. The brief also provides an overview of opportunities for other states interested in creating or enhancing integrated care programs.

This case study explores how health plans can help rebalance LTSS for dually eligible members. It looks at two California health plans who successfully transitioned dually eligible members from institutional to community settings. The case study uses these two examples to identify key elements for supporting dually eligible individuals with LTSS needs during the transition to living in the community.

The Centers for Medicaid & Medicare Services released a report that profiled the 10 states with the greatest change in Long-Term Services and Support (LTSS) system balancing. The report highlights characteristics of the 10 states and compares their change in LTSS system balancing with other states and provides a national overview on LTSS system balancing. State profiles consist of characteristics and strategies states utilized in their progress towards rebalancing their LTSS systems.

This is a report on the dual eligible financial alignment demonstrations. The Financial Alignment Initiative is a series of demonstrations launched in 2011 by the Medicare-Medicaid Coordination Office (MMCO) and the Center for Medicare and Medicaid Innovation within the Centers for Medicare and Medicaid Services (CMS).

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.