HMS Care Transitions Series: State Programs

There are several programs that offer financial support for performance measurement-related activities and technical assistance for state Medicaid and Children’s Health Insurance Program (CHIP) agencies seeking to improve the safety and effectiveness of care transitions and reduce readmissions. Examples of programs include:

State Demonstrations to Integrate Care for Dual-Eligible Individuals Design Contracts: 15 states have been selected to design new approaches to better coordinate care for dual-eligible individuals. The selected states will have up to 12 months to work with stakeholders to develop a detailed demonstration model describing how the state would structure and implement an intervention that aligns the full range of Medicare and Medicaid primary care, acute care, behavioral health, and long-term supports and services. States successfully completing their design contract may be eligible to receive support to implement their demonstration models, pending federal approval and funding availability.

Who is participating: California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington and Wisconsin were selected to receive design contracts as part of this effort.

Resources and technical assistance provided: The Center for Medicare & Medicaid Services (CMS) will provide funding and technical assistance to the selected states to develop person-centered approaches to coordinate care across primary, acute, behavioral health, and long-term supports and services for dual-eligible individuals. CMS is also making technical assistance available to all states interested in improving services for dual-eligible individuals.

Time of start and duration of the program design period: April 2011-April 2012; implementation will occur in 2012 and beyond.

Medicaid Community Services and Long Term Supports/ Medicaid Grant Programs: In partnership with states, consumers and advocates, providers, and other stakeholders, CMS is working to create a sustainable, person-driven long-term support system in which people with disabilities and chronic conditions have choice, control and access to a full array of quality services to assure optimal outcomes, such as independence, health and quality of life.

Next week, HMS continues our Care Transitions blog series with a look at community plans, learning opportunities and the elements of a successful care transitions program.

HHS: Medicare Advantage Enrollment Up

HMS Healthcare Management SolutionsAccording to an announcement from the Department of Health & Human Services (HHS),  enrollment in Medicare Advantage Plans, which include coverage for skilled nursing facility stays following acute episodes and special needs plans for chronically ill and disabled individuals such as dual eligibles, has jumped by 28% since the Patient Protection & Affordable Care Act (PPACA) was enacted in 2010.

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