South Carolina

South Carolina Capitated Financial Alignment Model Demonstration (Healthy Connections Prime)

 

SPOTLIGHT & RELEASES

01/11/2022: CMS released the Second Evaluation Report, and Findings at a Glance, for the South Carolina capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative. More information can be found below.
10/28/2021: CMS released the SC Contract & Summary of Changes (effective 01/01/2022). More information can be found below.

 

On October 25, 2013, the Centers for Medicare & Medicaid Services (CMS) announced that the state of South Carolina will partner with CMS to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience.

 

Under the demonstration, called Healthy Connections Prime, South Carolina and CMS will contract with Medicare-Medicaid plans to coordinate the delivery of and be accountable for covered Medicare and Medicaid services for participating Medicare-Medicaid enrollees. 

Key Dates

October 25, 2013 - CMS and South Carolina sign MOU

September 15, 2014 - CMS, South Carolina, and participating plans execute three-way contract 

February 1, 2015 - Start of opt-in enrollment

April 1, 2016 - Start of passive enrollment

November 1, 2017 - CMS, South Carolina, and participating plans execute three-way contract amendment

July 1, 2018 - CMS, South Carolina, and participating plans execute three-way contract amendment

July 1, 2020 - CMS, South Carolina, and participating plans execute three-way contract amendment

January 1, 2022 - CMS, South Carolina, and participating plans execute updated three-way contract

More information from CMS:

Information for Plans:

Information for Beneficiaries and Providers:

Information from the state of South Carolina:

Funding Support:


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Page Last Modified:
01/11/2022 07:00 PM