Using Health Homes to Integrate Care for Dually Eligible Individuals: Washington State’s Experiences
To provide more integrated, coordinated care for its residents who are dually eligible for Medicare and Medicaid, Washington State is operating a demonstration under the Financial Alignment Initiative offered by the Centers for Medicare & Medicaid Services. This case study describes: (1) the demonstration’s structure; (2) results achieved to date; and (3) insights on the demonstration’s implementation from the state and other stakeholders.
Overview of Model
Targeting higher-risk groups offers greater potential to demonstrate results. Based on the success of its prior chronic care management demonstrations, the state used its advanced data analytics systems to identify and target enrollment to dually eligible beneficiaries with the highest risk and highest costs