Implementing New Systems of Care for Dually Eligible Enrollees, Phase 3


Over the past five years, the federal Medicare–Medicaid Coordination Office has enabled state Medicaid agencies to test new ways of delivering and financing integrated care for some 10 million dual‐eligible beneficiaries. Of this group, approximately 8 million are considered full‐benefit Medicare–Medicaid enrollees, whose intensive and complex care needs account for a disproportionately high share of health expenditures. Such federal efforts as the Financial Alignment Initiative currently enjoy bipartisan support from federal officials and congressional leaders. Although participating states receive technical support, the Center for Health Care Strategies (CHCS), with Commonwealth Fund support, has been providing peer‐to‐peer learning and more intensive technical assistance than federal officials are able to offer. The CHCS team has developed a platform for states to share solutions and is producing information and tools that have accelerated development of replicable state practices. This final grant aims to consolidate and disseminate project lessons widely. In this third and final phase, the CHCS team will select 10 to 12 states on a competitive basis to receive technical support and guidance in identifying federal and state policy options for bringing integrated care to more Medicare–Medicaid dual eligibles. Activities will include an in‐person peer exchange meeting to explore high‐level policy issues; two to three video conferences focusing on policy topics and emerging innovations; and interviews with state officials to help pinpoint key factors for achieving integrated care for dual eligibles. Based on this work, CHCS will develop tools for advancing national policy to improve care for this population. With upcoming changes in administration at the federal and state levels, this project will maintain momentum for expanding care integration for dual eligibles while keeping opportunities for scaling up these efforts on the policy agenda. A separate Commonwealth Fund grant to the Innovation Network is supporting CHCS in its evaluation of the overall project’s impact.

Grant Details

Grantee Organization:
Center for Health Care Strategies, Inc.
Principal Investigator:
Stephen A. Somers, Ph.D.
Award Amount:
Approval Date:
November 8, 2016

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