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)
Program of All-Inclusive Care for the Elderly (PACE) organizations now serve a greater number of older adults with serious mental illness (SMI) than ever before, and increasingly include behavioral health providers in their care teams to meet the… (Center for Health Care Strategies)
This brief explores the experience of six states that have achieved varying levels of behavioral health and physical health integration or collaboration for dually eligible beneficiaries within a managed care environment. It describes: (1)… (Integrated Care Resource Center)
This brief describes how innovative states and Medicaid managed care organizations are building on models developed for physical health services and incorporating value-based purchasing arrangements into behavioral health programs.
(Center for Health Care Strategies)
This brief describes Commonwealth Care Alliance's development of enhanced residential crisis stabilization units that fill a gap in the behavioral health continuum of care available to enrollees in Massachusetts' Medicare-Medicaid… (Integrated Care Resource Center)
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 brief outlines considerations to guide state Medicaid agencies in successfully integrating behavioral health services within accountable care organizations, including decisions around financial strategies, data sharing, and quality measurement.
(Center for Health Care Strategies)
This brief describes early efforts in four states to improve integration of behavioral health services for Medicare-Medicaid beneficiaries.
(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 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 explores state options for integrating physical and behavioral health services within managed delivery systems, including examples of current state programs and critical considerations for implementation.
(Centers for Medicare & Medicaid Services)