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 Centers for Medicare & Medicaid Services (CMS) uses a five-star quality rating system to evaluate the performance of Medicare Advantage (MA) health plans. This Star Rating system enables beneficiaries, payers, and others to compare plans… (Integrated Care Resource Center)
This tip sheet is designed to help states that are planning procurements related to their integrated care programs for dually eligible individuals. It aims to help these states: (1) understand the relationship between state efforts to procure… (Integrated Care Resource Center)
This tip sheet details strategies states can use in their State Medicaid Agency Contracts (SMACs) with Dual Eligible Special Needs Plans (D-SNPs) to promote integration and coordination of behavioral health benefits among enrolled dually eligible… (Integrated Care Resource Center)
Integrating Dual Eligible Special Needs Plan Materials to Promote Enrollee Understanding of and Access to Benefits
Dual Eligible Special Needs Plans (D-SNPs) that operate with exclusively aligned enrollment and cover Medicaid benefits through the D-… (Integrated Care Resource Center)
This tip sheet describes the Medicare resources available to states to monitor Dual Eligible Special Needs Plan (D-SNP) performance, explains how states can leverage those resources for Medicaid managed care quality oversight and improvement, and… (Integrated Care Resource Center)
This resource was updated in June 2023 to correct an error in the definition of applicable integrated plan in the previous version.
Dual Eligible Special Needs Plans (D-SNPs) must hold contracts with state Medicaid agencies, and states can use… (Integrated Care Resource Center)
This tip sheet summarizes four key policy decisions for states preparing to implement EAE, as well as four factors that states may wish to consider when making those policy decisions.
(Integrated Care Resource Center)
This tip sheet provides a brief overview of exclusively aligned enrollment, as well as a summary of the benefits of EAE for dual eligible special needs plan (D-SNP) enrollees, providers, and states.
(Integrated Care Resource Center)
This tip sheet summarizes key considerations for states trying to decide which pathway to use to advance Medicare-Medicaid integration, and which Medicaid managed care authority(ies) might best support that pathway. Although the tip sheet presents… (Integrated Care Resource Center)
This webinar provides an overview of the role of ombudsman programs in integrated care programs serving dually eligible individuals. Using the ombudsman programs developed for the demonstrations under the Financial Alignment Initiative as an… (Integrated Care Resource Center)
On August 26, 2020 from 1:00-2:30 pm ET the Integrated Care Resource Center (ICRC) hosted a Study Hall Call on Medicare-Medicaid Plan (MMP) Enrollment Processing Updates Resulting from the Comprehensive Addiction and Recovery Act of 2016 (CARA… (Integrated Care Resource Center)
This webinar provides an update on new information-sharing requirements for Dual Eligible Special Needs Plans (D-SNPs) for 2021 and a review of key questions and considerations for states in working with D-SNPs to modify state contracts and… (Integrated Care Resource Center)
This webinar and accompanying presenation slides provide information on the historical Part A and Part B data across all eligibility responses, as well as an overview of the E&E360 Eligibility and Enrollment Online Portal.
Agenda:… (Integrated Care Resource Center)
Dual Eligible Special Needs Plans (D-SNPs) must develop a model of care (MOC) that describes their enrollees’ characteristics and health and service needs as well as the plan’s care coordination and health risk assessment processes. Despite the… (Integrated Care Resource Center)