Rhode Island
Integrated Care Initiative & Rhody Health Options (RHO)
Rhode Island implemented the first phase of its Integrated Care Initiative (ICI) in 2013. Operating under a Section 1115 Waiver, a managed care program known as Rhody Health Options (RHO) was launched to provide Medicaid benefits, including LTSS, to two populations: Medicaid beneficiaries receiving LTSS and other Medicaid beneficiaries who are also covered by Medicare ("duals"). In the second phase of the program, launched in 2016, a capitated duals demonstration program expanded upon RHO, thus allowing the state to provide duals with integrated Medicare and Medicaid services.
In the duals demonstration (Phase II of the ICI), there are two capitation rates for the Medicaid component: a blended Waiver/LTC rate for people on HCBS waivers or in nursing homes for longer than 90 days and a Community (non-LTSS) rate for everyone else.
More information
Program participant & expenditure data (see "State Expenditures for Long-Term Supports and Services under Managed Long Term Care")
Program documents
RHO contract with managed care organizations:
1115 Waiver Extension Application:
CMS Special Terms & Conditions for the 1115 Waiver:
Duals Demonstration (Phase II) Proposal Solicitation:
Duals Demonstration (Phase II) Three-Way Contract:
Supplemental quality reporting requirements:
Duals Demonstration (Phase II) Memorandum of Understanding with CMS:
Duals Demonstration (Phase II) Proposal to CMS:
Duals Demonstration (Phase II) capitation rate information:
Managed Care Quality Strategy: