Press Releases

New funding to improve care coordination for Medicare-Medicaid enrollees

New funding to improve care coordination for Medicare-Medicaid enrollees
Funding to support independent ombudsman services in new initiative designed to improve care for Medicare-Medicaid enrollees

Today, the Centers for Medicare & Medicaid Services (CMS) and the Administration for Community Living (ACL) announced a new funding opportunity designed to enhance the CMS’ Financial Alignment Initiative. The initiative is designed to improve coordination of care for Medicare-Medicaid enrollees. This funding opportunity will support states in developing independent ombudsman programs, helping beneficiaries in the demonstration have a positive care experience.

“These demonstrations are about ensuring Medicare-Medicaid enrollees have access to more coordinated care, making the health care system better for consumers and more efficient,” CMS Administrator Marilyn Tavenner said.  “This funding will make these demonstrations stronger by sharpening their focus on the beneficiary experience.”

“Ombudsman programs have proven to be a valuable resource for consumers. These experts bring skills in problem-solving and knowledge that empower consumers and their families through education and support,” ACL Administrator Kathy Greenlee, said.  “This ombudsman program will be critical to safeguarding consumer rights and maximizing the success of the program.”

Through the Financial Alignment Initiative, CMS is working with states to test two models – capitated and managed fee-for-service -- designed to improve the coordination of care for Medicare-Medicaid enrollees.  CMS has signed Memoranda of Understanding with six states to pursue demonstrations testing one of the two models.  Five of those states are pursuing a capitated model, under which participating states contract with Medicare-Medicaid plans to be accountable for and coordinate delivery of covered services for Medicare-Medicaid enrollees.

Today’s funding announcement will support the development of Demonstration Ombudsman Programs, which are designed to amplify the beneficiary voice in the Financial Alignment initiative.  These programs will provide beneficiaries with access to new resources and person-centered assistance in answering questions and resolving issues related to the demonstration. They will also carefully monitor the beneficiary experience, and offer recommendations to CMS, the states, and participating plans on how the initiative could be improved.

A fact sheet on today’s announcement is available at: http://cms.gov/Newsroom/Search-Results/index.html?q=&filter=Fact%20Sheets

For more information: https://www.cfda.gov/index?s=program&mode=form&tab=step1&id=09028306d8746a7697b172bdfd9b2807

For more information on the Financial Alignment Demonstration:
http://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialModelstoSupportStatesEffortsinCareCoordination.html

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