AGING AND LONG-TERM SUPPORT ADMINISTRATION

ALTSA > Medicare/Medicaid Integration Project

Medicare/Medicaid Integration Project

Achieving Washington State's vision of integrated Medicare and Medicaid services.

Integrated Care Vision

The Department of Social and Health Service's Aging and Disability and Health Care Authority are partnering with the Centers for Medicare and Medicaid Services (CMS) to integrate Medicare and Medicaid services for people who are dually eligible.  Our integration project is HealthPath Washington. 

The primary goals of HealthPath Washington include:

• Improve quality and coordination of care 
• Reduce expenditures
• Foster relationships with diverse stakeholders
• Share savings with the federal government

In April 2012, Washington state submitted our proposal to CMS, changes were negotiated and have been included in an addendum.  HealthPath Washington has two approaches Health Homes and Full Integration Capitation.  A timeline of activity for each approach summarizes our current progress.

Strategy 1: Health Homes (Managed Fee-For-Service)

Activity	Status
Memorandum of Understanding with CMS	Complete 10.24.12
Application Requests for Geographical Roll	Ongoing
State Plan Amendment	Submitted to CMS
Final CMS Agreement	Pending
Geographical implementation and enrollment	Target July 2013

Strategy 2:  Full Integration Capitation (Three Way Contracts between Health Plan/State/CMS)

Activity	Status
DRAFT Three Way Contract with Medicaid specific requirements that will be included in the Health Plan Request for Proposal (RFP). The DRAFT is subject to change dependent on discussions and negotiations with CMS to incorporate Medicare requirements.	11/30/2012
Healthpath Advisory Team Comments to Three Way Document	04/10/2013
Request for Applications RFA 2013 - HPW STRATEGY 2 FINANCIAL ALIGNMENT DEMONSTRATION RFA 2013 Revised 04/17/2013 Amendment 1 Exhibit A - letter of submittal Exhibit B - Model contract Exhibit B - Revised 04/17/2013 Exhibit C - Written proposal scoring tool EXHIBIT D - Certifications and Assurances Appendix A - HealthPlan Washington strategy 2 financial alignment demonostration graphic Appendix A Revised 04/17/2013 Appendix B - CMS Joint Rate-setting process under the capitated financial alignment initiative Appendix C - Attestation of compliance Appendix D - Partial list of responsibilities and duties that require mandatory State/Local Plan interaction Appendix E - Partial Profiles of the Dual Eligible Populations in King County and Snohomish Counties, 2010 Bidders Conference Registration Form	04/10/2013
Memorandum of Understanding with CMS	Pending
Health Plan Selection	Target July 2013

Contact Information

Karen Fitzharris, Project Director
Aging and Disability Services Administration
360.725.2254 or karen.digre-fitzharris@dshs.wa.gov

Renee C. Fenton, Communications Manager
Aging and Disability Services Administration
360.725.2270 or renee.fenton@dshs.wa.gov