The Centers for Medicare & Medicaid Services (CMS) announced the Healthy Adult Opportunity (HAO), which is an optional demonstration initiative.
The HAO initiative is designed to provide states:
- Greater flexibility to improve the health of their Medicaid populations while holding states accountable for a defined budget, the quality of care provided to beneficiaries, and providing access to high quality health care services.
- An opportunity to access a full array of waivers that historically have been provided by CMS- Benefits, cost sharing, retroactive eligibility, social determinants of health, additional conditions of eligibility.
- New opportunities for state innovation- Formulary opportunity to reduce drug costs, inclusion of FQHC services in value-based payment reform efforts, shared savings opportunity.
In a letter to State Medicaid Directors, CMS recognizes that states, as administrators of the program, are in the best position to assess the needs of their respective Medicaid-eligible populations and to drive reforms that result in better health outcomes.