CMS www.cms.gov is partnering with the New York State Department of Health’s (NYSDOH) www.health.ny.gov Office for People with Developmental Disabilities (OPWDD) www.opwdd.ny.gov. The partners will test a new model to provide Medicare and Medicaid enrollees with a more coordinated person-centered care experience.
New York State and CMS are working with Partners Health Plan to offer the new demonstration program to be known as “Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities” (FIDA-IDD). The idea is to serve individuals with intellectual and developmental disabilities and long term care needs who are eligible for both Medicare and Medicaid.
About 20,000 Medicare-Medicaid IDD enrollees in the New York downstate region that includes New York City, Long Island, plus Rockland and Westchester counties will be able to have an opportunity to receive more coordinated care as a result of this new program.
To help develop the demonstration, New York worked with a diverse group of stakeholders including individuals with developmental disabilities, parents, advocates, provider agency leaders and staff, and experts from outside the developmental disabilities service system.
The FIDA-IDD Demo will enable individuals to direct their own services, be involved in care planning, and live as independently in the community as possible. The participating FIDA-IDD Plan will have an interdisciplinary care team integrate the enrollee’s medical, behavioral health, long term services, and social needs.
The Demo will also ensure that enrollees can continue to see their current providers during their transition into the FIDA-IDD Plan. New York State has created an ombudsman program called the Independent Consumer Advocacy Network (ICAN) to help enrollees with appeals and other issues pertaining to the program.
CMS will fund and manage an external evaluation for the demonstration under the Financial Alignment Initiative. The evaluation for the demo will measure quality including overall beneficiary experience of care, care coordination, support of community living, as well as cost changes in Medicare and Medicaid.
This demonstration shares the general goals and structure of the Fully Integrated Duals Advantage (FIDA) demonstration which is already operating in New York, however the two demonstrations involve different populations and Medicare-Medicaid Plans.