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Michigan joins Medicare-Medicaid integration trend


The Centers for Medicare & Medicaid Services has partnered with Michigan to test efforts to improve care and contain costs for Medicare-Medicaid enrollees. The MI Health Link demonstration will integrate all services covered separately through Medicare and Medicaid into one healthcare delivery model, the Michigan Department of Community Health (MDCH) announced late last week.

"Our primary goal with MI Health Link is to improve quality and access to care for this vulnerable group of people who currently have to navigate two very different systems in Medicare and Medicaid," MDCH  Director James K Haveman said in the announcement.

Under the demonstration, Michigan and CMS will contract with integrated care organizations (ICOs)--health plans that must meet core Medicare and Medicaid requirements, state procurements standards and applicable state insurance rules. Every ICO also must pass a comprehensive CMS-state readiness review, according to a CMS fact sheet.

MI Health Link will run for three years in four regions of the state, with implementation expected to begin in July 2014. About 100,000 dual-eligibles will qualify for participation.

Working closely with stakeholders, the demonstration includes quality measures related to beneficiary overall experience and care coordination, among other factors, according to CMS.

As Michigan implements its demonstration program, the state should put more focus on quality-of-life measures. Test care models that coordinate benefits for dual-eligibles need stronger quality-of-life measures, which are essential to identifying effective innovations, according to a March policy brief from The Commonwealth Fund.

Michigan joins states like South Carolina, which launched a program to move more than 53,000 dual-eligibles into integrated managed care programs beginning this year. Massachusetts has combined its Medicare and Medicaid program as well, while about 18 other states plan to roll out similar mergers between now and 2015.

For more:
- here's CMS fact sheet
- check out the MDCH announcement

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