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 blog post looks at Idaho's Dual Eligible Special Needs Plan (D-SNP)-based program’s structure and highlights early successes and lessons for other states. Idaho’s approach may be interesting to states that want to integrate care, but do… (Center for Health Care Strategies)
This State Medicaid Director Letter highlights ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid. These opportunities, which do not require demonstration authority or Medicare waivers, fall into… (Centers for Medicare & Medicaid Services)
This informational bulletin informs states of two changes that may impact states’ payments for Medicaid beneficiaries in the nursing home setting.
(Centers for Medicare & Medicaid Services)
This resource is a model letter that D-SNPs have the option to use to meet CMS beneficiary notice requirements for default enrollment. All letters used will need to contain the required CMS disclaimers, materials ID and receive appropriate CMS… (Medicare-Medicaid Coordination Office)
This document describes the benefits of daily data exchanges with CMS. It also provides technical FAQs on buy-in data exchanges.
(Centers for Medicare & Medicaid Services)
This calendar of key Medicare Advantage dates describes program milestones by month and explains what activities state Medicaid agencies may want to undertake to prepare for or respond to a particular Medicare Advantage event.
(Integrated Care Resource Center)
The most recent demographic, enrollment, and expenditure data for dually eligible beneficiaries is in the zip file "State and County Data File 2012" found on the Medicare-Medicaid Coordination Office website. Additional data and statistical… (Centers for Medicare & Medicaid Services)
This blog describes pilot projects recently launched by six Cal MediConnect plans in Los Angeles and Orange County that will test interventions to reduce avoidable hospitalizations and other adverse events for nursing facility residents.
(California Department of Health Care Services)
The ability to direct and manage their own services and supports is important to many individuals who need the home- and community-based services (HCBS) provided through state Medicaid programs. These self-directed models may also be known as "… (Integrated Care Resource Center)
This document answers questions that states have asked about improving the processes they use to regularly identify prospective Medicare-Medicaid individuals for potential enrollment into their capitated financial alignment demonstrations.
(Integrated Care Resource Center)
This document describes the process that states and health plans participating in the capitated financial alignment demonstrations use to submit information to CMS' MARx systems.
(Centers for Medicare & Medicaid Services)
This document describes a Microsoft Access tool to prioritize information in the MARx system Daily Transaction Reply Report, and it explains states can use it to improve the timeliness and efficiency of their demonstration enrollment processes.
(Integrated Care Resource Center)
This report compares utilization of community-based services by dually eligible beneficiaries enrolled in a fully integrated managed care program to those of beneficiaries receiving Medicare and Medicaid services from separate delivery systems.… (Office of the Assistant Secretary for Planning and Evaluation [ASPE])