A Medicare Advantage Medicare-Medicaid plan (MMP) is a private health plan designed to provide integrated and coordinated Medicare and Medicaid benefits for dual eligible Medicare beneficiaries.
Unlike a Medicare Advantage Dual Eligible Special Needs Plan
(D-SNP), MMPs only serve full benefit dual eligible (Medicare/Medicaid) beneficiaries and some additional limitations may apply (such as state-specific requirements).
As noted by the Centers for Medicare and Medicaid Services (CMS):
"A Medicare-Medicaid Plan (MMP) [like a D-SNP] is a private health plan that has been competitively selected and approved to provide integrated care to eligible full-benefit Medicare-Medicaid enrollees under the CMS Financial Alignment Demonstration."
CMS also notes that MMPs are only allowed to operate in select counties within states that have completed a three-step CMS approval process culminating in a three-way contract between CMS, the state, and the MMP provider.
Medicare-Medicaid plans were introduced in 2014 and are only offered in a few counties across the country..
- In 2021 and 2022, only 43 MMPs were offered across the country
as compared to 3,072 local HMO Medicare Advantage plans. To read more about changes in the 2021
Medicare Advantage landscape, please see our article at https://Q1News.com/859.html.
- In 2020, there were only 44 MMPs offered across the country as compared to 2,777 local HMOs. To see more about changes in the 2020
Medicare Advantage landscape, please see our article at https://Q1News.com/783.html.
CMS, “Financial Alignment Initiative,”
(www.cms.gov/ Medicare-Medicaid-Coordination/ Medicare-and-Medicaid-Coordination/ Medicare-Medicaid-Coordination-Office/ FinancialModelstoSupportStates EffortsinCareCoordination.html.)