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State Design Contract Summaries

In December 2010, CMS announced the State Demonstrations to Integrate Care for Dual Eligible Individuals, a competitive solicitation for proposals to design person-centered models that coordinate primary, acute, behavioral and long-term supports and services for Medicare-Medicaid enrollees.  All States were eligible to apply.

Upon thorough evaluation by a technical review panel, 15 States were selected to receive up to $1 million to support the design of programs to better coordinate care for dual eligible individuals.  The 15 States are California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota*, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington and Wisconsin.  The States selected:

  • Met the goal of aligning the full range of Medicare and Medicaid primary care, acute care, behavioral health and long-term supports and services; and 
  • Demonstrated a medium to high level of readiness, to ensure timely implementation.

The twelve-month design period began April or May 2011, depending on the State’s contract execution date. Selection for a design contract does not constitute Federal approval or endorsement for any proposal or implementation activities associated with these plans.  The primary deliverable of the design contract will be a detailed demonstration model describing how each State would structure and implement its proposed integrated program.  States are required to engage in significant work with their stakeholder community during the design phase to ensure broad and ongoing stakeholder input on their implementation proposal All final proposals will undergo thorough Federal review; CMS will work with States to implement the plans that hold the most promise.

Each of the 15 selected States has provided a description of its initial proposal to CMS, which is summarized below.  The selected States are in different stages of development and will use the design contract period to further develop their approaches; as such, the level of detail provided in the summaries varies by State

In addition to the States receiving these awards, CMS will also be working closely with all States that request assistance in improving care coordination for dual eligible individuals through the establishment of a technical assistance resource center.

For more information, e-mail us at: MedicareMedicaidCoordination@cms.hhs.gov

 *pending legislative approval