Capitated Model

This brief provides suggestions for designing and implementing integrated care initiatives that are of high quality, offer attractive benefits and services, and provide easy-to-understand education, outreach, and marketing information. It also describes strategies for retaining enrollees in these initiatives.

This brief provides basic information on Medicare Part D, including how beneficiaries are enrolled in Part D, how Part D drugs are paid for, what drugs are and are not covered in Part D, how drug utilization is managed in Part D, and how the Part D Medication Therapy Management Program works.

This document answers questions that states have asked about improving the processes they use to regularly identify prospective Medicare-Medicaid individuals for potential enrollment into their capitated financial alignment demonstrations.

This document describes the process that states and health plans participating in the capitated financial alignment demonstrations use to submit information to CMS' MARx systems.

In this presentation, CMS and MassHealth staff provide different perspectives on the challenges and successes of the three-way contracting process in Massachusetts, including discussion of managing timeframes and interacting with health plans.

This background paper examines the contents of states' proposals in the areas of target population, implementation date, enrollment, financing, benefits, beneficiary protections, stakeholder engagement, and demonstration evaluation.

This report describes early implementation activities occurring in the first six months of the seven financial alignment demonstrations launched as of May 1, 2014.

This brief explores opportunities for states to develop an integrated appeals process, whether through a D-SNP or a financial alignment demonstration.