Washington State’s Medicaid program and the federal Centers for Medicare and Medicaid Serviceson Monday signed a memorandum of understanding that will allow a unique joint Medicaid-Medicare program aimed at better care for elderly and disabled clients and shared savings for the two government programs.
The initiative – which will be centered in Snohomish and King counties – was announced in both Washington, D.C., and Olympia.
The project is part of a series of innovative demonstrations to integrate care in a number of states, but Washington will be one of the first Medicaid programs to partner with Medicare in this way. In the past, most savings have not been shared, which meant there were fewer incentives for the programs to work together. Critics of the current system argue that it encourages silo-type thinking that winds up duplicating services and care.
The Department of Social and Health Services and the Health Care Authority have been collaborating on the initiative with county representatives who have helped in the design of the model and in the health plan selection process.
“Working with CMS is a milestone in our efforts to track and better serve the so-called ‘dual eligibles’ – those Medicaid clients who are also covered by Medicare,” said MaryAnne Lindeblad, state Medicaid director. “We will be providing integrated medical, behavioral health, and long-term services and supports in those two urban counties, looking to set standards that ultimately will be used by other states as well as our own.”
“We believe this will be a breakthrough that will improve alignment of Medicaid and Medicare benefits for the people we serve,” said Jane Beyer, assistant secretary for Behavioral Health and Service Integration in the Department of Social and Health Services. “We believe that it will reduce health disparities and better fit care with client needs, especially for people with complex care needs.”
The project is a second approach in a two-part initiative dubbed HealthPathWashington. The first part, or strategy, is an initiative that uses Health Homes in the other 37 Washington counties to provide improved care and better coverage for ongoing services.
The second strategy announced Monday will be evidence-based and focused on leveling the uneven field of services now delivered by different kinds of provider organizations – chemical dependency treatment, mental health, long-term services and supports and medical services – and achieve better outcomes, efficiencies and cost containment because the services will be managed more reliably by a single entity.
The three-way contract will be signed by the state, CMS and the two health plans that bid successfully on the project – Regence BlueShield and United Healthcare.
The state will enroll eligible clients in the program but will allow them to opt out and continue to receive existing service delivery. American Indians/Alaska Natives will have the opportunity to enroll, but must actively choose to enroll.
Key objectives are:
- Evaluate an innovative payment and service delivery model
- Promote person-centered care planning
- Promote more independence in the community
- Achieve cost savings for both the state and federal government
- Make sure that the right care is available at the right time and the right place.
FOR MORE INFORMATION OR BACKGROUND:
Medicare/Medicaid Integration Project website: www.aasa.dshs.wa.gov/