The Centers for Medicare and Medicaid Services on Friday said a demonstration of new incentives to align dual-eligible spending shows a 6 percent savings, or $21.6 million, in Medicare spending.
The preliminary results are from a Washington Health Homes demonstration under the Medicare-Medicaid Financial Alignment Initiative, CMS said.
From July 2013 to December 2014, Medicare spending was reduced by $21.6 million relative to a comparison group, representing more than 6 percent savings, according to CMS.
This demonstration sought to leverage Medicaid health homes to improve service quality and integration, while reducing costs of care for high-risk, high-cost Medicare-Medicaid enrollees referred to as dual eligibles.
More than 10.7 million Americans are enrolled in both the Medicare and Medicaid programs, CMS said.
A longstanding barrier to improving quality and reducing costs of care for Medicare-Medicaid enrollees has been a lack of alignment and cohesiveness between the two programs, including misaligned incentives for payers and providers, according to CMS.
The report also includes early quality and utilization results, eligibility and enrollment data, characteristics of the population eligible for the demonstration, beneficiary focus group findings, and a discussion of the initial implementation experience.
CMS will partner with states to test two new models: capitated, in which a health plan enters into a three-way contract, and the plan receives a prospective blended payment to provide comprehensive, coordinated care; and the managed fee-for-service model in which a state would be eligible to benefit from savings resulting from initiatives designed to improve quality and reduce costs for both Medicare and Medicaid.
Participating states are: California, Colorado, Illinois, Massachusetts, Michigan, Minnesota, New York, Ohio, South Carolina, Texas, Virginia and Washington.
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