The Medicare-Medicaid Coordination Office (MMCO) recently released additional information related to the joint rate-setting process for the Medicare-Medicaid Capitated Financial Alignment Model that will serve as a central component to the Coordinated Care Initiative (CCI). This financial alignment model aims to integrate Medicare and Medicaid financing in an effort to create more person-centered care, improved health outcomes and lower overall costs. It is the basis for the duals demonstration projects going on in different states throughout the country.
What this means for California is that both Medicare and Medicaid will coordinate in setting payment levels for the CCI working to achieve savings for both entities. The predicted savings will come from improvement, including better care coordination to reduce certain high-cost services such as repeated visits to the hospital or emergency room. Savings will not come from reducing payment to providers or reducing access to services, as both the payment to providers and access to services will remain the same under the CCI as it is today.
The full document is available for more information on how the payment rates for plans will be developed to ensure coordination of primary, acute, behavioral health and long-term supports and services for dual eligible enrollees in demonstrations under the Capitated Financial Alignment Model.