Issue Brief: Special Populations Enrolled in Demonstrations under the Financial Alignment Initiative

Jul 18, 2018
This Issue Brief provides an update on the beneficiary experience in the first two demonstrations that were implemented as part of the Centers for Medicare & Medicaid Services (CMS) Financial Alignment Initiative to test integrated care and financing models for Medicare-Medicaid enrollees. The Washington Health Homes MFFS demonstration, a managed fee-forservice model demonstration, and the Massachusetts One Care demonstration, a capitated model demonstration, began operations on July 1st and October 1st of 2013, respectively. For the purposes of this report, special populations encompass the following: (1) enrollees who use long-term services and supports (LTSS) which include nursing facilities, personal care services, residential care facilities, and adult day care; (2) enrollees with behavioral health needs, including those with serious and persistent mental illness (SPMI) such as schizophrenia and bipolar disorder; and (3) linguistic, ethnic, and racial minorities enrolled in the demonstrations. The purpose of this brief is to report how enrollees who use these services are faring under the Washington and Massachusetts demonstrations and to understand if disparities in services and demonstration experiences exist for these groups.
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