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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 1 - 15 of 17

Brief | March 2022
Preventing and Addressing Unnecessary Medicaid Eligibility Churn Among Dually Eligible Individuals: Opportunities for States
People who are dually eligible for Medicare and Medicaid benefits often have multiple chronic physical and behavioral health conditions, and many use long-term services and supports (LTSS).1 Unfortunately, a relatively high proportion of dually… (Integrated Care Resource Center)
Brief | March 2021
State Approaches to Developing and Operating Ombudsman Programs for Demonstrations under the Financial Alignment Initiative
Ombudsman programs can offer beneficiary protections as part of Medicaid managed care programs. These programs are particularly important for beneficiaries with complex physical and behavioral health conditions, including many dually eligible… (Integrated Care Resource Center)
Brief | September 2019
Information Sharing to Improve Care Coordination for High-Risk Dual Eligible Special Needs Plan Enrollees: Key Questions for State Implementation
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)
Brief | August 2019
Promoting Information Sharing by Dual Eligible Special Needs Plans to Improve Care Transitions: State Options and Considerations
This brief examines the approaches used by three states – Oregon, Pennsylvania, and Tennessee – to develop and implement information-sharing processes for their Dual Eligible Special Needs Plans (D-SNPs) that support care transitions. The brief… (Integrated Care Resource Center)
Brief | January 2019
An Exploration of Consumer Advisory Councils within Medicare-Medicaid Plans Participating in the Financial Alignment Initiative
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)
Brief | July 2017
Medicaid Agency Partnerships with State Health Insurance Programs: Opportunities to Improve Care for Medicare-Medicaid Enrollees
This brief describes opportunities for Medicaid agencies to partner with State Health Insurance Assistance Programs (SHIPs) in educating Medicare-Medicaid enrollees and their families on new integrated care program options. (Integrated Care Resource Center)
Brief | June 2017
State and Health Plan Strategies to Grow Enrollment in Integrated Managed Care Plans for Dually Eligible Beneficiaries
This brief outlines a variety of actions that states and health plans can take to support enrollment growth in integrated care programs. (Integrated Care Resource Center)
Brief | January 2016
Communicating Early Results of Integrated Care Efforts for Dually Eligible Individuals: State Approaches
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)
Brief | December 2015
Assessing Success in Medicare-Medicaid Integration: A Review of Measurement 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)
Brief | May 2015
The Star Rating System and Medicare Advantage Plans
This brief examines how star rating are calculated and considerations around how differences among beneficiary populations should be recognized. (National Health Policy Forum)
Brief | January 2015
Integrated Appeals Processes for Medicare-Medicaid Enrollees: Lessons from States
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)
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)
Brief | December 2014
Contacting Hard-to-Locate Medicare and Medicaid Members: Tips for Health Plans
This brief provides tips on finding hard-to-locate members from seven health plans participating in a national initiative focused on advancing health plan strategies to provide high-quality, cost-effective care for high-need populations eligible for… (Center for Health Care Strategies)
Brief | July 2014
Moving Toward Integrated Marketing Rules and Practices for Medicare and Medicaid Managed Care Plans
This brief provides an overview of managed care marketing requirements in both Medicare and Medicaid, highlights the different sets of rules, and outlines steps taken to better align them. (Integrated Care Resource Center)
Brief | March 2014
Assessing Care Integration for Dual-Eligible Beneficiaries: A Review of Quality Measures Chosen by States in the Financial Alignment Initiative
This brief reviews the quality measures chosen by eight states taking part in CMS' capitated model financial alignment demonstrations as of December 2013. (The Commonwealth Fund)