Capitated Model

Financial Alignment Initiative for Beneficiaries Dually Eligible for Medicaid and Medicare

This brief describes the design of the Financial Alignment Initiative and compares key provisions of the 10 capitated model demonstrations. Separate fact sheets are available on each of the 10 demonstrations.

Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

This paper gives an overview of the proposals submitted by states to test two models to align Medicare and Medicaid benefits and financing for dually eligible beneficiaries with the goal of delivering better coordinated care and reducing costs.

Experiences with Financial Alignment Initiative Demonstration Projects in Three States: Feedback from Enrollees in California, Massachusetts, and Ohio

This report describes beneficiary experiences with enrollment processes, communication about the model of care, and understanding of care coordination services under the capitated model financial alignment demonstrations.

Communicating Early Results of Integrated Care Efforts for Dually Eligible Individuals: State Approaches

This brief describes approaches that states have used to communicate early integrated care program results. Strategies discussed include developing program indicator dashboards, disseminating beneficiary experience data, and sharing success stories.

Capitated Financial Alignment Model Plan Guidance

This memo provides guidance to organizations interested in offering capitated financial alignment demonstration plans.

An Update on CMS's Capitated Financial Alignment Demonstration Model for Medicare-Medicaid Enrollees

This policy brief describes the capitated financial alignment demonstration model, including information on financing, enrollment, provider network adequacy, medical necessity determinations, appeals, and quality and oversight.