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CMS, Rhode Island partner on new dual-eligible care model

July 30, 2015
by Pamela Tabar, Editor-in-Chief
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The Centers for Medicare & Medicaid Services is partnering with the state of Rhode Island to try out a new model for providing person-centered care to Medicare/Medicaid dual enrollees. Instead of having benefits managed separately, dual-eligibles in the pilot will have their Mediare and Medicaid benefits managed together under the same health management plan, including long-term services and supports.

Rhode Island already has an integrated managed care program—Rhody Health Options—for its Medicaid residents. Under the joint demonstration project with CMS, the Rhody program will be allowed to serve as a Medicare benefits manager as well, for residents who are eligible for both Medicare and Medicaid.

The project will explore whether bringing the Medicare and Medicaid services for dual eligibles under one management system will better align services, care coordination and the management of chronic illnesses, while also smoothing out the gnarled pathways to access often experienced by beneficiaries who have to juggle the two health benefits systems separately.

Read more about the CMS/RI project here.