About MMPs and CMMI Demonstrations

Medicare-Medicaid Plans (MMPs)

The Center for Medicare & Medicaid Innovation conducts and sponsors numerous innovative demonstration projects and model tests to measure the effect of potential program changes. CMMI demonstrations and model tests study the likely impact of new methods of service delivery, coverage of new types of service, and new payment approaches on beneficiaries, providers, health plans, states, and the Medicare Trust Funds. Evaluation projects validate our research and demonstration/model findings and help us monitor the effectiveness of Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Click here for more info.

A Medicare Advantage MMP is a private health plan that provides coordinated Medicare and Medicaid benefits for dually eligible individuals. MMPs simplify the processes for dual eligible individuals to access the care they are entitled to under Medicare and Medicaid programs. This includes providing beneficiaries with a seamless enrollment and disenrollment process and access to high-quality integrated healthcare.

MMPs differ from SNPs in that they are a totally aligned product designed to further strengthen the coordination of Medicare and Medicaid Services. An MMP is an alignment initiative in which Medicare and Medicaid benefits are offered as a single plan in a three-way contract between CMS, the state Medicaid agency (SMA), and the health plan; a D-SNP model is when a health plan holds a contract with Medicare and then a separate contract with the SMA to provide Medicaid benefits at varying levels of integration.

About MMP Integration

The Centers for Medicare & Medicaid Services (CMS) Financial Alignment Initiative is testing models to better integrate primary, acute, behavioral health, and long-term services and supports, providing participating states to share in savings.

Fifteen states were initially awarded demonstration contracts, and implementation began in 2013.

The two models include (1) a prospective blended rate model for select health plans to provide both Medicare and Medicaid benefits to duals called the “capitated model”, and (2) a model that allows the state to take responsibility for coordinating the beneficiary’s care, called a “managed fee-for-service model (MFFS)”.

For more information about MMPs, D-SNPs and Medicare-Medicaid Integration click on the links below:

MMPs Serve 385,959 Beneficiaries

As of January 2020, 9 states are participating in the capitated model (CA, IL, MA, MI, MN, OH, RI, SC, TX) with total enrollment of 385,959 (January 2020).

  • One state is in the managed fee-for-service model (WA) with enrollment of about 33,000 (September 2017)
  • One additional state (MN) has an agreement with CMS for an alternative FIDE-SNP demonstration focused on administrative alignments with enrollment of about 38,570
  • Two demonstrations have ended (VA and CO) though additional care coordination was continued
  • All of the demonstrations are, as of May 2020, in process of being extended

Enrolling in Medicare-Medicaid Plans

States participating in the capitated model demonstrations are required to follow National MMP Enrollment Guidance & Exhibits. Each state has specific guidelines that contain a detailed description of the requirements for enrolling.

Learn More About Enrolling in MMPs here

Relevant Statutes & Reports

The SNP Alliance is pleased to provide current and archived information about SNP and MMP contracts, SNP types, locations, and enrollment compiled each month by the CMS Health Plan Management System. The information is also available on the CMS website.

View the Latest Comprehensive Reports