Integrated Care Activities

  • Financial Alignment Demonstration: Capitated model
    Dual Eligible Special Needs Plan Contracting: Yes
    Medicaid Managed Long-Term Services: No
    Approved Medicaid Health Home: No
    Program of All-Inclusive Care for the Elderly (PACE): Yes

Related Resources

  • Other Resource

    Key Demonstration Documents on the MMCO Website

    These documents, including Ohio's proposal, three-way contract, readiness review tool, and evaluation design plan, are posted on the Medicare-Medicaid Coordination Office's website. (Centers for Medicare & Medicaid Services)
  • Other Resource

    Ohio State Website

    This website provides information on MyCare Ohio -- the capitated model Financial Alignment Initiative in Ohio. (Ohio Department of Medicaid)
  • Other Resource

    State and County Data File, 2012

    The most recent demographic, enrollment, and expenditure data for dually eligible beneficiaries is in the zip file "State and County Data File 2012" found on the Medicare-Medicaid Coordination Office website. Additional data and statistical resources for the years 2007, 2008, 2009, and 2011 can be found in the Medicare-Medicaid Enrollee State Profiles. See also Defining Medicare-Medicaid Enrollees in CMS Data Sources. (Centers for Medicare & Medicaid Services)
    Topic: Data for Medicare-Medicaid Integration
  • Other Resource

    Early Insights From Ohio's Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    This case study describes the early implementation of Ohio's capitated financial alignment demonstration. (Kaiser Family Foundation)
  • Technical Assistance Tool

    Monthly Enrollment in Medicare-Medicaid Plans by Plan and by State, January 2018 to January 2019

    This resource reports data on the most recent 12 months of enrollment in the capitated model financial alignment demonstrations. (Integrated Care Resource Center)
    Topic: Enrollment
  • Technical Assistance Tool

    Monthly Enrollment in Medicare-Medicaid Plans by Plan and by State, October 2019 to October 2020

    This resource reports data on the most recent 12 months of enrollment in capitated model demonstrations under the Financial Alignment Initiative. (Integrated Care Resource Center)
    Topic: Enrollment
  • Case Study

    The MyCare Ohio Demonstration: Early Successes and Stakeholder Insights on Integrating Care for Dually Eligible Beneficiaries

    To provide more integrated, coordinated care for its residents who are dually eligible for Medicare and Medicaid, Ohio is operating a demonstration under the Financial Alignment Initiative offered by the Centers for Medicare & Medicaid Services. This case study describes: (1) the demonstration’s structure; (2) results achieved to date; and (3) insights on the demonstration’s implementation from the state and other stakeholders. (Integrated Care Resource Center)
    Topic: Financial Alignment Demonstrations, Capitated Model
  • Technical Assistance Tool

    Monthly Enrollment in Medicare-Medicaid Plans by Plan and by State, November 2020 to November 2021

    This resource reports data on the most recent 12 months of enrollment in capitated model demonstrations under the Financial Alignment Initiative. (Integrated Care Resource Center)
    Topic: Enrollment
  • Brief

    State Approaches to Developing and Operating Ombudsman Programs for Demonstrations under the Financial Alignment Initiative

    Ombudsman programs can offer beneficiary protections as part of Medicaid managed care programs. These programs are particularly important for beneficiaries with complex physical and behavioral health conditions, including many dually eligible individuals. For the demonstrations under the Financial Alignment Initiative, the Centers for Medicare & Medicaid (CMS) and states incorporated ombudsman programs to help to resolve enrollees’ problems and alert Medicare-Medicaid Plans (MMPs), states, and CMS of emerging trends and issues. This technical assistance brief compares approaches that states took in structuring ombudsman programs and discusses the benefits and challenges of both models. It also examines the services offered by ombudsman programs and the value these programs have brought to the demonstrations. This brief is designed to help state Medicaid agencies that are developing beneficiary support systems or implementing new integrated care programs to better understand the full range of beneficiary needs within their dually eligible populations and how ombudsman programs or similar support systems could bring value to their efforts. (Integrated Care Resource Center)
    Topic: Financial Alignment Demonstrations, Quality and Performance Measurement, Background on Long-Term Services and Supports, Assessment, Care Planning, and Care Coordination
  • Other Resource

    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. (Medicaid and CHIP Payment and Access Commission)
    Topic: Capitated Model, Beneficiary Engagement, Counseling, and Support
  • Other Resource

    Report on Early Implementation of Demonstrations under the Financial Alignment Initiative

    This report describes early implementation activities occurring in the first six months of the seven financial alignment demonstrations launched as of May 1, 2014. (RTI International)
    Topic: Capitated Model, Managed Fee-for-Service Model
  • Brief

    Risk Stratification to Inform Care Management for Medicare-Medicaid Enrollees: State Strategies

    This brief describes how three states - California, Ohio, and Virginia - are requiring Medicare-Medicaid Plans to stratify Medicare-Medicaid enrollees by their level of need within capitated financial alignment demonstrations. (Center for Health Care Strategies)
    Topic: Assessment, Care Planning, and Care Coordination