The demonstration project is part of CMS’ Financial Alignment Initiative, which aims to provide Medicare-Medicaid dual eligibles with a better care experience. The Texas project involves a capitated model, under which the state and CMS will contract with health plans or other qualified entities that will receive a prospective, blended payment to provide dual eligibles with coordinated care.
Texas already operates the STAR+PLUS program, which provides enhanced care coordination to Medicaid enrollees who are older than 65 or are disabled. Under the demonstration project with CMS, Medicare-Medicaid plans will cover Medicare benefits in addition to the benefits covered through STAR+PLUS.
The project will take place in six counties and will involve 168,000 eligible individuals, according to CMS. Enrollment will begin March 1, 2015.
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