The state Department of Human Services (DHS) has posted for public comment a draft proposal for a demonstration project that would integrate healthcare services for clients enrolled in both Medicare and Medicaid.
Approximately 27,000 individuals in Hawaii are enrolled in the programs concurrently.
Clients enrolled in both programs currently receive Medicaid-covered services through Hawaii’s QUEST Expanded Access (QExA) program. Under the proposed demonstration, those same covered services will be combined with Medicare services, and delivered through the QExA health plans.
The integrated program creates a single, inclusive package of preventive, acute, pharmacy and long-term services that otherwise are covered by Medicare or Medicaid.
The primary goal of the proposed demonstration is to provide a coordinated, accessible and intuitive member-centric healthcare delivery system.
The expected cost savings generated from the integration would be shared between the State and the Centers for Medicare and Medicaid Services (CMS), the federal agency that administers Medicare and works in partnership with states to administer Medicaid.
To align with the launch of services under the new QExA health plan contracts, the DHS has set a target date of Jan. 1, 2014 to implement the proposed demonstration. Re-procurement for the QExA health plan contracts is expected to begin by the end of calendar year 2012.
The draft proposal for the demonstration will be posted on the DHS website for a 30-day period during which the public can submit comments. Comments received by close of business on Thursday, May 17, 2012 will be reviewed and incorporated as appropriate into the revised document. That document will be submitted to CMS for approval.