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.
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 examines how states will need to build their information systems and internal capacity for data analysis as they pursue integrated care programs for Medicare-Medicaid enrollees.
(Center for Health Care Strategies)
This brief presents considerations for provider network development, reviews recent guidance, and offers examples of state practices for establishing MLTSS network adequacy standards.
(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 brief discusses concrete, actionable steps that states can take to move toward more integrated care for Medicare-Medicaid enrollees.
(Integrated Care Resource Center)
This brief discusses strategies for structuring rates for managed long-term services and supports programs to encourage the use of home- and community-based services and details states experiences in setting rates for these programs.
(Center for Health Care Strategies)
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 reviews primary care case management and related models to gather insights into key program design elements in managed fee-for-service models.
(Integrated Care Resource Center)
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)
This brief discusses the reasons why it is important to engage stakeholder groups; how to identify distinct audience groups within stakeholder community; and how to target messages to specific groups.
(Center for Health Care Strategies)
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)
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)