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.
The Centers for Medicare and Medicaid Services (CMS) Financial Alignment Initiative (FAI) tested models to better integrate primary, acute, behavioral, and long-term services and supports. FAI also provided participating states to share in savings. Fifteen states were initially awarded demonstration contacts 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)”.
All FAI evaluation reports are available on CMS’ website here: https://www.cms.gov/priorities/innovation/innovation-models/financial-alignment
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.
