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.
The Center for Consumer Engagement in Health Innovation released a report The Biggest Value is Getting the Voice of the Member describing its findings on the composition, function, and impact of the Consumer Advisory Councils operating within… (Center for Consumer Engagement in Health Innovation)
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 describes the design of the Financial Alignment Initiative and compares key provisions of the 10 capitated model demonstrations. Separate fact sheets are available on each of the 10 demonstrations.
(Medicaid and CHIP Payment and Access Commission)
This brief explores opportunities for states to develop an integrated appeals process, whether through a D-SNP or a financial alignment demonstration.
(Center for Health Care Strategies)
This issue brief examines key themes in 19 capitated Medicaid MLTSS waivers approved to date by the Centers for Medicare and Medicaid Services (CMS), including section 1115 (a) demonstrations in 12 states and 1915 (b)/(c) waivers in six states.
(Kaiser Family Foundation)
This brief examines how providers, health plans, and community-based organizations in three counties experienced California’s transition of approximately 240,000 seniors and people with disabilities to Medicaid managed care.
(Kaiser Family Foundation)
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 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 brief examines key policy and operational considerations related to the transition from fee-for-service to risk-based capitated managed care for LTSS.
(Kaiser Family Foundation)
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)
This policy brief describes the capitated financial alignment demonstration model, including information on financing, enrollment, provider network adequacy, medical necessity determinations, appeals, and quality and oversight.
(Kaiser Family Foundation)
This brief examines issues in the development and implementation of managed care programs for Medicaid beneficiaries with disabilities, particularly policy considerations related to setting rates, developing provider networks and delivery systems,… (Kaiser Family Foundation)