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.
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… (Integrated Care Resource Center)
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”… (Integrated Care Resource Center)
This webinar describes what Medicare and Medicaid data are publicly available and some simple tools that states can use to begin to explore these data. For states that are ready to undertake more in-depth analyses of Medicare data, the… (Integrated Care Resource Center)
This technical assistance tool shows states how to use data on Medicare-Medicaid dually eligible beneficiary demographics, service utilization, spending, and other characteristics to create tables, graphs, and figures and interpret their meaning for… (Integrated Care Resource Center)
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.
(Integrated Care Resource Center)
This document offers the Centers for Medicare & Medicaid Services' (CMS) guidelines for permissible goods and services, and can be customized to include additional state guidelines.
(Integrated Care Resource Center)
This document reviews the individual's rights under the self-directed option as well as his or her associated responsibilities for participation.
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This tip sheet suggests steps that managed care plans can take to ensure that case managers are effectively trained on approaches to promote person-centered planning in self-directed delivery models for home- and community-based services.
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This questionnaire helps individuals and health plan case managers to select an appropriate person to be informally designated as a representative decision-maker.
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This tip sheet offers suggestions for states operating managed long-term services and supports programs or other managed integrated care programs to: (1) understand the person-centered planning process; (2) establish robust contract requirements and… (Integrated Care Resource Center)
This questionnaire helps case managers to assess the ability of an individual to self-direct services, and if the individual requires assistance from a representative.
(Integrated Care Resource Center)
This tool gives examples of the roles and responsibilities of the individual, representative, case manager, information and assistance function, the financial management services function, and the direct care worker.
(Integrated Care Resource Center)
This resource suggests topics to be covered in a policies and procedures manual for the day-to-day management of the self-direction program. Programs should add topics as needed to ensure efficient and consistent program operations.
(Integrated Care Resource Center)
This document answers common questions about self-direction including: (1) what is self-direction and why is it an important option for individuals receiving HCBS; (2) what are the components of self-direction. The document also defines self-… (Integrated Care Resource Center)