Rhode Island Partners With CMS on Care Coordination


Rhode Island is entering into a new partnership with the Centers for Medicare and Medicaid services. The partnership will amount to a pilot aimed at improving care coordination for Medicare and Medicaid enrollees.

Approximately 30,000 Medicare-Medicaid enrollees in Rhode Island will be eligible to participate in the pilot.

Rhode Island has an existing statewide patient care integration plan, and that plan will form the basis of the CMS partnership. Under the current state plan, Medicaid members enroll in a health plan that coordinates all of their Medicaid services including long-term care. In the pilot, some of those enrollees will be able to switch to a qualifying health plan that will serve as a Medicare-Medicaid Plan (MMP). Under the new plan, coverage will be provided for both Medicare and Medicaid.

The goal is to provide care options for each stage of patient care, and make healthcare more affordable for low-income individuals who may qualify for both Medicaid and Medicare. Improving the care experience for low-income seniors and people with disabilities who are Medicare-Medicaid enrollees – sometimes referred to as “dual eligibles” – is a priority for CMS.

Enrollment for the new plan is slated to begin at the end of this year.

As part of the pilot, CMS will fund and manage an external evaluation process, which will monitor the dual-eligible plan to see if it does improve quality of care.

The full MOU is available here.