Data for Medicare-Medicaid Integration

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.

This resource shows how states can use data from the Centers of Medicare and Medicaid to create tables, graphs, and figures and interpret their meaning in order to assess D-SNP performance.

These profiles provide demographic, enrollment, and expenditure data for Medicare-Medicaid Enrollees.