Establishing linkages between Medicaid service and payment policies and Medicare delivery systems reform demonstrations being implemented in a state will lead to more effective care coordination for dual eligible beneficiaries.

*Milestone details:

*Full name: Design interfaces between the Medicare and Medicaid delivery systems reform demonstrations created by the ACA.

*Relevance to the ACA:

Many of the Medicare service delivery systems and payment reform demonstrations are targeted to beneficiaries with multiple chronic conditions and/or limitations in activities of daily living, many of whom are likely to be dual eligibles. As a result these demonstrations are likely to have some impact on Medicaid service delivery systems in states where they are being implemented. In addition, care coordination for dual eligibles enrolled in these demonstrations will be enhanced through better linkages with Medicaid programs. Following are some of the most relevant Medicare demonstrations.

§3023 – Medicare National Pilot Program on Payment Bundling.

§3022/10307 and §3027 – Medicare Shared Savings Program, Extension of Medicare Gainsharing Demonstration, both relating to accountable care organizations.

§3024 - Independence at Home Program.

§3026 - Community Based Transitions at Home Program.

§3140 - Medicare Hospice Concurrent Care Demonstration Program.