Minnesota’s Demonstration to Integrate Care for Dual Eligibles

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The Minnesota Department of Human Services (DHS) is building on current state initiatives to improve performance of primary care and care coordination models for dual eligibles served in integrated Medicare and Medicaid Special Needs Plans and fee-for-service delivery systems. Dual eligibles refer to people who have benefits through Medicare and Medicaid, known in Minnesota as Medical Assistance.

Existing initiatives include integrated Medicare and Medicaid Special Needs Plan managed care programs such as Minnesota Senior Health Options (MSHO) and Special Needs BasicCare (SNBC), implementation of health care homes including the Medicare Advanced Primary Care Practice demonstration, and provider payment reform through the Health Care Delivery System demonstration. Proposed improvements include development of system-wide performance measures, risk adjustments, provider feedback systems and risk/gain sharing models specific to the dually eligible population.

Minnesota is working with the federal Centers for Medicare & Medicaid Services (CMS) to stabilize Medicare Advantage Special Needs Plans’ participation and to further integrate Medicare into these initiatives.

To access more information on this topic, please go to Public meetings. These meetings will be held periodically to share information on the demonstration and get input from clients, stakeholders and other interested parties.

Status update on the Dual Demo

May 12, 2014
On September 12, 2013, DHS and the Centers for Medicare and Medicaid Services (CMS) signed a Memorandum of Understanding (MOU) establishing a Demonstration to Align Administrative Functions for improvements in Beneficiary Experience (Demonstration). This demonstration began on September 13, 2013 and continues until December 31, 2016 and is designed to reduce costs associated with beneficiaries eligible for both Medicare and Medicaid, or dual eligibles. (For historical information please go to Dual Demo historical information). The demonstration’s Dual Demo Work Plan is also available for review.

Status update on the Integrated Care System Partnerships

DHS’ Health Care and Continuing Care Administrations requested public input on best practices for development of Integrated Care System Partnerships (ICSPs) between managed care organizations and primary, acute, long-term care and mental health providers serving seniors and people with disabilities under managed care programs. The ICSPs are especially for people with dual Medicare and Medicaid eligibility, including those enrolled in MSHO, Minnesota Senior Care Plus (MSC+) and SNBC.

Per the 2013 contract, all health plans submitted ICSP proposals with identified quality measures by July 15, 2013. A total of 30 proposals were received across eight health plans respectively, with all 30 proposals approved by DHS.

On October 1, 2013 health plans confirmed contracts are in place with identified partners for each ICSP and ready for implementation starting January 1, 2014. To access the October 3, 2013 Stakeholder’s meeting, go to Stakeholder presentation, and for historical information related to ICSPs please go to ICSPs historical information.

Related information

Minnesota DHS contacts

For more information, contact:
Pamela Parker
, Manager of Minnesota’s Special Needs Purchasing
Dr. Jeff Schiff
, Medical Director for Minnesota Health Care Programs
Deb Maruska
, Minnesota’s dual demo project coordinator

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