18 Of 26 States Moving To Capitated Payments For Integrated Dual Eligible Plans

Of the 26 states pursuing new financial alignment models to integrate care for people eligible for both Medicare and Medicaid, 18 are planning to implement a capitated payment model; six are pursuing a managed fee-for-service (FFS) model; and two are pursuing both models. The federal Centers for Medicare and Medicaid Services (CMS) is testing the models for states to better align the financing of the Medicare and Medicaid programs and integrate primary, acute, behavioral health and long term services and supports.

Under the capitated model, the state, CMS, and a health plan will enter into a three-way . . .