Medicare and Medicaid Alignment Initiative
CMS has also initiated an Alignment Initiative to identify and address conflicting requirements between Medicaid and Medicare that create potential barriers to high quality, seamless, and cost-effective care for dual eligible beneficiaries. There are tremendous opportunities for CMS to partner with States, providers, beneficiaries and their caregivers, and other stakeholders to improve access, quality, and cost of care for people who depend on these two programs. The goal is to create and implement solutions in line with CMS’s three-part aim, comprised of solutions that advance better care for the individual, better health for populations, and lower costs through improvement. As a first step, CMS has asked for public input to help create a foundation for future collaboration to address the issues. It is especially interested in:
- Ensuring that dual eligible individuals are provided full access to the Medicare and Medicaid program benefits
- Simplifying the processes for dual eligible individuals to access the items and services guaranteed under the Medicare and Medicaid programs
- Eliminating regulatory conflicts between the rules under the Medicare and Medicaid programs
- Improving care continuity and ensuring safe and effective care transitions for dual eligible beneficiaries
- Eliminating cost-shifting between the Medicare and Medicaid programs and between related health care providers
CMS published the Notice pursuing alignment opportunities on May 16, 2011. CMS received over 100 responses from beneficiaries, advocates, professional health associations, plans and States on improving care for Medicare-Medicaid enrollees. Section 2602(c) of the Affordable Care Act established specific goals, and the Alignment Initiative has provided an effective means to engage the public and help meet these goals. CMS is currently working through the comments and will be developing a work plan identifying next steps to improve coordination between the programs.