Helping states develop integrated programs for individuals who are dually eligible for Medicare and Medicaid
This analysis examines trends in enrollment and eligibility for Medicare-Medicaid enrollees.
MedPAC Data Book on Medicare Spending
New ICRC Tools Help States Identify Dually Eligible Individuals and Aligned Enrollees
Want to Know More about the Dually Eligible Individuals in Your State? Request a State Data Profile
July 2020 Enrollment in Medicare-Medicaid Plans
July 2020 Enrollment in PACE Organizations
New Resources on the ICRC Website
Key Upcoming Dates
States need to be able to identify individuals who are (or will become) dually eligible for several reasons. Since 2005, states have exchanged files -- known as the Medicare Modernization Act (MMA) files -- with the Centers for Medicare & Medicaid Services (CMS) that identify current and prospective dually eligible individuals. This technical assistance tools explains how states can identify Medicaid enrollees who are currently dually eligible, as well as Medicaid enrollees who will become dually eligible in the next three months (known as “prospective” dually eligi
States can advance integrated care for dually eligible individuals by promoting aligned enrollment in Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) and Medicaid managed care plans owned by the same parent company (“affiliated” plans). Dually eligible individuals who receive Medicare and Medicaid coverage from affiliated plans can benefit from improved integration of benefits and care coordination.
April 2020 Update Contents:
This webinar describes what Medicare and Medicaid data are publicly available and some simple tools that states can use to begin to explore these data. For states that are ready to undertake more in-depth analyses of Medicare data, the State Data Resource Center describes no-cost technical assistance resources that can help states to access, analyze, and interpret Medicare data.
This technical assistance tool shows states how to use data on Medicare-Medicaid dually eligible beneficiary demographics, service utilization, spending, and other characteristics to create tables, graphs, and figures and interpret their meaning for a wider audience of stakeholders.
This document describes the benefits of daily data exchanges with CMS. It also provides technical FAQs on buy-in data exchanges.
The most recent demographic, enrollment, and expenditure data for dually eligible beneficiaries is in the zip file "State and County Data File 2012" found on the Medicare-Medicaid Coordination Office website.