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Medicaid Transformation

The state is leading strategic changes within Medicaid, allowing us to move toward a healthier Washington. The Medicaid Transformation is an agreement with the federal government which allows us to test new and innovative approaches to providing health coverage and care.

Frequently requested resources

What is Medicaid Transformation?

The Medicaid Transformation is a five-year agreement between the state and the Centers for Medicare and Medicaid Services (CMS) that provides up to $1.5 billion federal investment for regional health system transformation projects that benefit Apple Health (Medicaid) clients.

What are the initiatives under the transformation?

Transforming the Medicaid delivery system within each region to care for the whole person and use resources more wisely through Accountable Communities of Health. Learn more about Initiative 1.

Expanding options for people receiving long-term services and supports so they can stay at home and delay or avoid the need for more intensive services, and supporting families in caring for loved ones while increasing the well-being of caregivers. Learn more about Initiative 2.

Foundational Community Supports (FCS) is also referred to as Initiative 3. FCS helps our most vulnerable beneficiaries get and keep stable housing and employment, in support of their broader health needs. Learn more about Initiative 3.

This initiative allows Washington State to make improvements and use federal funds participation for Medicaid SUD treatment services in facilities that are “institutions for mental diseases” (IMDs). It relaxes restrictions on the use of federal funds to pay for people receiving SUD treatment in a mental health or SUD facility, for an average of 30 days. Learn more about Initiative 4

This initiative allows Washington State to purchase (an average of 30 days) acute inpatient services for Medicaid clients between the ages of 21 and 65 who reside in a dedicated large psychiatric facility that qualifies as an “institution for mental diseases” (IMD). Learn more about Iniative 5