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 several administrative changes that state Medicaid programs can make to: (1) support integration efforts; (2) improve beneficiaries’ experience of care; (3) decrease beneficiary out-of-pocket costs; and (4) reduce provider… (Integrated Care Resource Center)
This brief explains Medicaid's role in providing supplemental coverage to Medicare beneficiaries. It also provides data on Medicaid spending for Medicare beneficiaries.
(Kaiser Family Foundation)
This brief highlights insights from states that are fine-tuning their integrated care programsandcan help other states design their own integrated care programs to meet beneficiaryneeds.
(Center for Health Care Strategies)
This brief provides an overview of four integration models: (1) Dual Eligible Special Needs Plan-based; (2) Financial Alignment Initiative-based; (3) the Program of All-Inclusive Care for the Elderly; and (4) accountable care organizations and… (Center for Health Care Strategies)
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 introduces a framework outlining the key attributes of high-performing health plans that are necessary to support integrated care for Medicare-Medicaid enrollees.
(Center for Health Care Strategies)
This brief highlights best practices in disease management/care management programs and considers ways in which states can incorporate them into integrated care models like CMS’ Financial Alignment Initiative for Medicare-Medicaid… (Integrated Care Resource Center)
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 brief discusses concrete, actionable steps that states can take to move toward more integrated care for Medicare-Medicaid enrollees.
(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 describes nine core program elements that are critical for achieving high-quality, patient-centered, and cost-effective care for dually eligible beneficiaries.
(Center for Health Care Strategies)