Healthy Adult Opportunity Demonstration

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.

• Healthy Adult Opportunity State Medicaid Director Letter
• Health Adult Opportunity 1115 Application Template
• Healthy Adult Opportunity Press Release
• Healthy Adult Opportunity Fact Sheet
• Medicaid Facts and Figures