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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.

Displaying 31 - 45 of 64

Other Resource | June 2016
Data-Driven Strategies - Analyzing Opt-Outs and Engaging Beneficiaries and Providers
This document describes the process that states and health plans participating in the capitated financial alignment demonstrations use to submit information to CMS' MARx systems. (Centers for Medicare & Medicaid Services)
March 2016
Medicaid Managed Long-Term Services and Supports: Themes from Site Visits to Five States
During site visits to five states (Arizona, Florida, Illinois, New York, and Wisconsin), researchers identified major themes related to the rapid growth of Medicaid managed long-term services and supports (MLTSS) programs and the diversity of ways… (Mathematica)
Other Resource | October 2015
FY 2016 Medicare Hospice Payment Reform - Final Policies
This presentation describes the new Medicare hospice payment rules and system updates that states will need to make to comply with the rules. (Centers for Medicare & Medicaid Services)
June 2015
Community-Based Care Transition Program
The Community-Based Care Transitions Program (CCTP) supported by the CMS Center for Medicare & Medicaid Innovation tests models for improving care transitions from the hospital to other settings and reducing readmissions for high-risk Medicare… (Centers for Medicare & Medicaid Services)
May 2015
Report to Congress: The Centers for Medicare & Medicaid Services' Evaluation of For-Profit PACE Programs under Section 4804(b) of the Balanced Budget Act of 1997
This report presents information on the frailty level, access to care, and the quality of care of PACE participants enrolled with for-profit PACE organizations as compared to not-for-profit PACE organizations and is based on the <a href="… (Centers for Medicare & Medicaid Services)
March 2015
HCBS Basic Element Review Tool for Statewide Transition Plans Version 1.0
This tool will be used by CMS to perform compliance reviews on state Home and Community Based Services (HCBS) Transition Plans. (Centers for Medicare & Medicaid Services)
Other Resource | January 2015
Enrollment and Retention Flexibilities to Better Serve Medicare-Eligible Medicaid Enrollees
This CMS Informational Bulletin describes existing flexibilities that can: (1) assist states in meeting their obligations to screen Medicaid enrollees for Medicare Savings Programs and other categories of Medicaid when the enrollees become Medicare-… (Centers for Medicare & Medicaid Services)
Brief | December 2014
Measuring Up: A Novel Approach to Assessing State Oversight of Medicaid Managed Care
This brief assesses Washington State's oversight of Medicaid managed care plan performance under the state's 1915 (b) waiver by quantifying monitoring practices and comparing them to benchmarks inside and outside of Washington State. (Mathematica)
June 2014
Self-Direction Program Options for Medicaid Payments in the Implementation of the Fair Labor Standards Act Regulation Changes
This informational bulletin summarizes guidance on implementing Section 2402 (a) of the Affordable Care Act, the provision that requires all states develop systems for delivering person-centered planning and self-direction of home and community-… (Centers for Medicare & Medicaid Services)
November 2013
Encounter Data Toolkit
This toolkit provides a practical guide to collecting, validating, and reporting Medicaid managed care encounter data and is designed as a guide for state Medicaid staff responsible for managing the daily operations involved in encounter data, as… (Mathematica)
Technical Assistance Tool | October 2013
Application of Existing External Quality Review Protocols to Managed Long Term Services and Supports
This tool is a road map for states to use in interpreting and applying existing External Quality Review protocols when assessing Medicaid MLTSS program compliance. (Centers for Medicare & Medicaid Services)
May 2013
Summary of Essential Elements of Managed Long Term Services and Supports Programs
This document provides a summary of the ten key elements that CMS expects to see incorporated into new and existing state Medicaid MLTSS programs. (Centers for Medicare & Medicaid Services)
May 2013
Guidance to States Using 1115 Demonstrations or 1915 (b) Waivers for Managed Long Term Services and Supports Programs
This document describes the ten key elements that CMS expects to see incorporated into new and existing state Medicaid MLTSS programs. (Centers for Medicare & Medicaid Services)
Other Resource | February 2013
Toward a More Perfect Union: Creating Synergy Between the Money Follows the Person and Managed Long-Term Services and Supports Programs
This report examines how five states have structured the interface between MFP demonstration grants and Managed long-term services and supports (MLTSS) programs to promote transitions from institutional care to home- and community-based settings. (Mathematica)
January 2012
Capitated Financial Alignment Model Plan Guidance
This memo provides guidance to organizations interested in offering capitated financial alignment demonstration plans. (Centers for Medicare & Medicaid Services)