HHS Initiatives Provide Flexibility for States to Improve Medicaid

The U.S. Department of Health and Human Services announced four initiatives to give states more flexibility to adopt innovative new practices and provide better coordinated care for people with Medicaid and Medicare last week.

According to HHS, fifteen states will receive federal funding to develop better ways to coordinate care for people with Medicare and Medicaid coverage, also known as dual eligibles, who often have complex and costly health care needs.  All states will also receive increased flexibility to provide home and community-based services for more people living with disabilities.

“Medicaid programs provide health coverage for millions of low-income Americans who otherwise would lack access to health care,” said HHS Secretary Kathleen Sebelius.  “With these new resources and flexibilities, states will have new options to make their Medicaid programs work better for the people they serve, while helping lower their costs.”


Funded by the Affordable Care Act, the 15 states will receive up to $1 million each to develop new ways to meet the often complex and costly medical needs of the approximately nine million Americans who are eligible for both the Medicare and Medicaid programs, known as “dual eligibles.”

“Beneficiaries who are in both Medicare and Medicaid can face different benefit plans, different rules for how to get those benefits and potential conflicts in care plans among providers who do not coordinate with each other,” said Donald M. Berwick, M.D., administrator of CMS.  “This can be disastrous for those beneficiaries who are most vulnerable and in need of help.”

Other initiatives include more money to develop simpler and more efficient information technology (IT) systems to modernize Medicaid enrollment.  Under the new rules, HHS will provide 90-percent of the cost for states to develop and upgrade their IT systems to help people enroll in Medicaid or the Children’s Health Insurance Program (CHIP) – and 75-percent of ongoing operational costs.


For more information, see here.