Financial Alignment Actuarial and Rate Review Services

Provide the Centers for Medicare & Medicaid Services (CMS) with actuarial, rate-review, and analytic services to support the ongoing operations of Medicare-Medicaid financial alignment model demonstrations for individuals enrolled in both Medicare and Medicaid (dually eligible beneficiaries). These demonstrations are opportunities for CMS and states to test new approaches to providing integrated, high-quality care to dually eligible beneficiaries.

The contractor awarded this contract will provide actuarial services, rate-review, analytic services, and technical assistance for the ongoing operation of these demonstrations in multiple states. The work will include the review of the Medicaid components of the capitated payment rates for Medicare-Medicaid Plans (MMPs) under capitated demonstrations and ongoing analytic work to monitor demonstration financing issues.