Medicaid and Medicare together provide health coverage for approximately 12.2 million low-income seniors and people with disabilities who are dually eligible for both programs. The Centers for Medicare & Medicaid Services’ Medicare-Medicaid Coordination Office has implemented the Financial Alignment Initiative, a three-year demonstration project, to improve care and reduce program costs for these beneficiaries, as well as improve coordination between the Medicaid and Medicare programs.
As of January 2022, 11 states participate in the Financial Alignment Initiative either under a capitated model, a managed fee-for-service model, or an alternative model. This fact sheet provides a brief summary of Illinois’s capitated demonstration model. It provides updated information on enrollment, opt-out rates, and changes to consumer protection and care coordination requirements.