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.
This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage network adequacy requirements and their application to D-SNPs.
(Integrated Care Resource Center)
This presentation describes the approach of health plans in Arizona and Minnesota to managing care transitions by Medicare-Medicaid enrollees and other beneficiaries with complex conditions.
(Integrated Care Resource Center)
In this presentation, CMS and MassHealth staff provide different perspectives on the challenges and successes of the three-way contracting process in Massachusetts, including discussion of managing timeframes and interacting with health plans.
(Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to consumer protection including marketing, member materials and education, continuity of care, and grievance and appeals processes.
(Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to care coordination including the structure of the care team, development of care plans, caseload requirements, and use of a centralized enrollee record.
(Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to behavioral health including coordination of behavioral health services, network availability of behavioral health services, and inclusion of behavioral health… (Integrated Care Resource Center)
This brief looks at the paths pursued by Florida, New Jersey, and Virginia in implementing MLTSS approaches focused on helping individuals to live in their communities rather than nursing facilities.
(Center for Health Care Strategies)
This brief examines how states will need to build their information systems and internal capacity for data analysis as they pursue integrated care programs for Medicare-Medicaid enrollees.
(Center for Health Care Strategies)
This brief presents considerations for provider network development, reviews recent guidance, and offers examples of state practices for establishing MLTSS network adequacy standards.
(Center for Health Care Strategies)
This brief provides suggestions for designing and implementing integrated care initiatives that are of high quality, offer attractive benefits and services, and provide easy-to-understand education, outreach, and marketing information. It also… (Integrated Care Resource Center)
This webinar explains participant direction and how it can be included in contract language; also describes how Arizona implemented consumer direction in its long-term care system.
(Integrated Care Resource Center)
This technical assistance tool provides states with options to evaluate health plans' past performance as they consider those plans for participation in their integrated Medicare-Medicaid programs.
(Integrated Care Resource Center)
This brief provides basic information on Medicare Part D, including how beneficiaries are enrolled in Part D, how Part D drugs are paid for, what drugs are and are not covered in Part D, how drug utilization is managed in Part D, and how the Part D… (Integrated Care Resource Center)
The National Resource Center for Participant-Directed Services explains participant direction and how it can be included in contract language, and staff from the Arizona Health Care Cost Containment System give an example of how Arizona implemented… (Integrated Care Resource Center)
This case study highlights a chronic conditions special needs plan (C-SNP) for Medicare and dual eligible beneficiaries with serious mental illness that integrates physical and behavioral health services for enrollees.
(Center for Health Care Strategies)