States seeking to integrate Medicare and Medicaid services for dually eligible beneficiaries need to consider a variety of issues in program design and implementation such as incorporating behavioral health and long-term services and supports, consumers and providers engagement, and linking Medicare and Medicaid data. Use the filter below to view resources related to these and other topics.
Starting January 1, 2021, Coordination Only (CO) Dual Eligible Special Needs Plans (D-SNPs) are required to notify the state Medicaid agencies that they contract with (or the states' designees) of hospital and skilled nursing facility admissions for… (Center for Health Care Strategies)
This blog post looks at Idaho's Dual Eligible Special Needs Plan (D-SNP)-based program’s structure and highlights early successes and lessons for other states. Idaho’s approach may be interesting to states that want to integrate care, but do… (Center for Health Care Strategies)
Program of All-Inclusive Care for the Elderly (PACE) organizations now serve a greater number of older adults with serious mental illness (SMI) than ever before, and increasingly include behavioral health providers in their care teams to meet the… (Center for Health Care Strategies)
This third edition of the scorecard measures state performance in creating a high-quality system of care for older adults and people with physical disabilities, and their family caregivers. The report presents results across five dimensions: (1)… (AARP Public Policy Institute)
This brief describes how innovative states and Medicaid managed care organizations are building on models developed for physical health services and incorporating value-based purchasing arrangements into behavioral health programs.
(Center for Health Care Strategies)
This brief explores how health plans are: (1) addressing dually eligible members’ service needs that are beyond the scope of traditionally covered Medicare or Medicaid services; (2) assessing the value of offering these services; and (3)… (Center for Health Care Strategies)
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… (Center for Health Care Strategies)
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.
(Center for Health Care Strategies)
This resource center gives states tools for developing or refining rate-setting methods for Medicaid managed long-term services and supports (MLTSS) or Medicare-Medicaid integrated care programs.
(Center for Health Care Strategies)
This brief describes key considerations for developing interdisciplinary care teams and explores how eight states addressed issues such as engaging providers and measurement approaches.
(Center for Health Care Strategies)
This brief describes approaches that states have used to communicate early integrated care program results. Strategies discussed include developing program indicator dashboards, disseminating beneficiary experience data, and sharing success stories.
(Center for Health Care Strategies)
This brief examines considerations for rate setting in Medicaid managed long-term services and supports (MLTSS) programs and spotlights the experiences of eight statesin establishing MLTSS payment rates.
(Center for Health Care Strategies)
This brief examines the potential of current and planned measures to accurately assess the performance of integrated care programs for dually eligible individuals.
(Center for Health Care Strategies)
This report summarizes care coordination models and care coordinator responsibilities in Medicaid managed long-term services and supports programs in 18 states.
(AARP Public Policy Institute)
Concerns about care transitions between acute and long-term services and supports (LTSS) settings have been raised since at least the 1990s. More recently, studies have emphasized the growing need to address care transitions from nursing homes to… (AARP Public Policy Institute)