Helping states develop integrated programs for individuals who are dually eligible for Medicare and Medicaid
This resource was updated in June 2023 to correct an error in the definition of applicable integrated plan in the previous version.
This State Medicaid Director Letter invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial Alignment models; (2) managed fee-for-service Financial Alignment models; and (3) state-specific models.
This State Medicaid Director Letter highlights ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid.
On April 24, 2019, CMS released a State Medicaid Director Letter that invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial Alignment models; (2) managed fee-for-service Financial Alignment models; and (3) state-specific models.
This brief highlights best practices in disease management/care management programs and considers ways in which states can incorporate them into integrated care models like CMS’ Financial Alignment Initiative for Medicare-Medicaid enrollees and other state initiatives for high-cost, high-need Medicaid beneficiaries.
This brief highlights insights from states that are fine-tuning their integrated care programsandcan help other states design their own integrated care programs to meet beneficiaryneeds.
This brief provides an overview of four integration models: (1) Dual Eligible Special Needs Plan-based; (2) Financial Alignment Initiative-based; (3) the Program of All-Inclusive Care for the Elderly; and (4) accountable care organizations and similar entities.
This brief describes nine core program elements that are critical for achieving high-quality, patient-centered, and cost-effective care for dually eligible beneficiaries.