The states are expected to design or test their cost-effective multi-payer payment and delivery systems for Medicare, Medicaid, and Children's Health Insurance Program enrollees with input from stakeholders across the care delivery spectrum, including private payers, providers, employers, and community leaders.
Model Testing awards totaling $225 million will be available for five states over the next three or four years that can demonstrate that they are ready to implement their already developed integrated care models.
The remaining $50 million in the Model Design pot will be divided between 25 states that are not as far along the implementation continuum. The money will be used to provide financial and technical assistance for those states as they decide what types of systems improvements would work best for them.
Kaye says HHS recognizes that different states will require different care delivery designs.
"What works in Vermont may not work in Texas, and what worked in Texas may not work in Idaho. But part of what worked in Vermont may work in Idaho," she said. "It isn't that you do everything in lock step but certainly you could align incentives and align approaches which would make it easier on the providers and also enable the payers to send a consistent message."