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Joint Rate-Setting Process FAQs | February 8, 2013

This document describes a joint rate-setting process for Medicare-Medicaid capitated financial alignment model. Through this model, participating health plans are responsible for delivering an integrated set of services for Medicare-Medicaid enrollees. This initiative will test whether aligning Medicare and Medicaid financing can foster more person-centered care models of care, achieve better outcomes, and lower costs through improvement.

Through this joint rate-setting process, Medicare and Medicaid will coordinate in setting payment levels and both payers will prospectively share in the savings achievable through the demonstrations.

  • Available on the CMS-MMCO Website:  The Joint Rate-Setting Process for the Capitated Financial Alignment Model | PDF
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