On December 12, the Centers for Medicare and Medicaid Services (CMS) entered into a Memorandum of Understanding (MOU) with the Ohio Office of Medical Assistance to create an 'Integrated Care Delivery System' for dual eligibles (people eligible for Medicare and Medicaid).  The MOU is part of the Medicare-Medicaid Coordination Office's Financial Alignment demonstration.  Ohio becomes the third state to execute a MOU under the demonstration and the second state to employ a risk-based capitated model.

The MOU introduces three elements to the MOU that were absent in previous agreements: the requirement for an ombudsman program, a minimum medical loss ratio, and long-term services and supports quality measures. Under the MOU, beginning in September 2013, Ohio will enroll up to 115,000 dual eligibles into Integrated Care Delivery System (ICDS) plans, or managed care plans, who will be responsible for delivering all covered Medicare and Medicaid services to plan enrollees.

NSCLC has prepared a brief summary of the Ohio MOU with an emphasis on elements related to beneficiary protections.  As this is just the second MOU approving a capitated program, the Ohio agreement offers some insight into how state demonstration plans will vary, and the overall direction of the Financial Alignment demonstration.