Early insights from Commonwealth coordinated care: Virginia's demonstration to integrate care and align financing for dual eligible beneficiaries
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Summer, Laura, author Hoadley, Jack, author
- Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
- Publication:
- Menlo Park, CA : Henry J. Kaiser Family Foundation, June 2015
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Delivery of Health Care, Integrated Dual MEDICAID MEDICARE Eligibility Program Evaluation United States Virginia
- Genre(s):
- Technical Report
- Abstract:
- Virginia is among the early states to launch a 3-year capitated financial alignment demonstration to integrate Medicare and Medicaid payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This report describes the early implementation of Virginia's capitated demonstration, Commonwealth Coordinated Care (CCC). Findings are based on interviews conducted with a diverse group of state leaders, including representatives from state agencies; medical, behavioral health, and social services providers; consumer advocates; and health plans, involved in the design and early implementation of the CCC program. The report also includes data on enrollment in CCC to provide context for the qualitative findings. CCC launched in April 2014, and as of January 10, 2015, had enrolled 27,333 beneficiaries, about 42 percent of the population estimated to be eligible for the program, most of whom (84 percent) were automatically assigned to a health plan and enrolled in the program, and the remainder (16 percent) voluntarily enrolled on their own. About 40 percent of all eligible beneficiaries across the state have opted out of the program, with the remaining 18 percent not yet enrolled. The Virginia demonstration includes the following features: (1) focuses on a comprehensive population of adult dually eligible beneficiaries, including seniors, people with physical disabilities, and people with behavioral health needs; (2) includes beneficiaries residing within five regions of the state; (3) allows beneficiaries to opt out of the demonstration for both their Medicare and Medicaid benefits; (4) covers both community-based and institutional long-term services and supports (LTSS), including Medicaid home and community-based waiver services for seniors and people with physical disabilities; (5) requires a minimum medical loss ratio for health plans and offers financial incentives for health plans to provide home and community-based services; and (6) sets aside funds for an early state-specific evaluation.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (22 pages, 1 unnumbered page))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101670699 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101670699