Today the Centers for
Medicare & Medicaid Services (CMS) is announcing a new opportunity to
support states with greater flexibility to improve the health of their
Medicaid populations. The Healthy Adult Opportunity (HAO) Demonstration
emphasizes the concept of value-based care while granting states with
extensive flexibility to administer and design their programs within a
defined budget.
States will have
broad flexibility to operate an HAO demonstration project to maximize
health outcomes for Medicaid populations in a cost-effective,
administratively efficient manner. For the first time, CMS is providing
flexibilities currently available to states in a comprehensive suite of
pre-packaged waiver authorities.
To offer states this
option, the HAO will involve the use of section 1115(a)(2) authority to
provide coverage to individuals not eligible for benefits under the state’s
Medicaid state plan, while affording states maximum flexibility in the
administration of benefits for such individuals. HAO is available to states
for a limited population – adults under age 65 who are not eligible for
Medicaid on the basis of disability or need for long term care services and
supports, or are not eligible under a state plan.
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