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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.

Displaying 1 - 14 of 14

Other Resource | June 2024
Lessons Learned from Dual Eligible Special Needs Plans Enrollee Advisory Committee Strategic Conversation
Other Resource | August 2022
Guidance for States Seeking to Leverage New Opportunities for Integrated Care Programs
This memorandum provides states with guidance on the process for working with the Centers for Medicare & Medicaid Services (CMS) to establish Dual Eligible Special Needs Plans (D-SNP)-only contracts and develop integrated materials. The Contract… (Centers for Medicare & Medicaid Services)
Tip Sheet, Other Resource | April 2022
Dually Eligible Individuals: The Basics
ICRC has developed a basic fact sheet on individuals who are dually eligible for Medicare and Medicaid. (Integrated Care Resource Center)
Other Resource | May 2020
Updated Guidance for Medicare Advantage Organizations
This memo provides answers to questions related to two CMS memos released on April 21 and April 23 for Medicare Advantage and Part D plans (including D-SNPs and Medicare-Medicaid Plans (MMPs)) describing guidance for plans related to the COVID-… (Centers for Medicare & Medicaid Services)
Other Resource | April 2020
Updated Guidance for Medicare Advantage Organizations
This memo provides updated information related to previously issued April 21, 2020 guidance, "Information Related to Cronavirus Disease 2019 - COVID-19." (Centers for Medicare & Medicaid Services)
Other Resource | April 2020
Announcement of Calendar Year (CY) 2021 Medicare Advantage (MA) Capitation Rates and Part C and D Payment Policies
This memo describes the annual capitation rate for each Medicare Advantage payment area for CY 2021 and the risk and other factors to be used in adjusting these rates. (Centers for Medicare & Medicaid Services)
Other Resource | April 2020
Updated CMS Processes for Dual Eligible Special Needs Plan (D-SNP) Implementing CY 2021 Medicare-Medicaid Integration and Unified Appeals and Grievance Requirements in Response to Coronavirus Disease 2019 (COVID-19)
In response to the unique circumstances resulting from D-SNPs’ and states’ priority focus on reducing the risks of COVID-19 transmission and maintaining continuity of operations, this memorandum outlines updated CMS processes for review and approval… (Centers for Medicare & Medicaid Services)
Other Resource | January 2020
Additional Guidance on CY 2021 Medicare-Medicaid Integration Requirements for Dual Eligible Special Needs Plans (D-SNPs)
This HPMS memo provides additional guidance and clarification on four topics related to new integration standards for Dual Eligible Special Needs Plans: (1) distinctions between fully integrated D-SNPs (FIDE SNPs) and highly integrated (… (Centers for Medicare & Medicaid Services)
Other Resource | March 2019
People Dually Eligible for Medicare and Medicaid
In 2017, there were 12 million individuals dually eligible for Medicare and Medicaid. This fact sheet provides information on their reasons for Medicare eligibility, costs of care, and enrollment in managed care as well as the… (Centers for Medicare & Medicaid Services)
Brief | February 2017
Medicaid's Role for Medicare Beneficiaries
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)
June 2016
Report to the Congress: Medicare and the Health Care Delivery System -- Chapter 9: Issues Affecting Dual-Eligible Beneficiaries: CMS's Financial Alignment Demonstration and the Medicare Savings Program
This chapter of MedPAC's June 2016 report reviews the progress of the financial alignment demonstrations and analyzes options for Medicare Savings Programs. (Medicare Payment Advisory Commission)
April 2016
Key Components for Successful LTSS Integration: Lessons from Five Exemplar Plans. Working Paper 1: Project to Develop the Business Case for LTSS Integration
This report analyzes the key components that affect integration of medical care and long-term supports and services for Medicaid and Medicare-Medicaid enrollees in managed care plans. (Long-Term Quality Alliance)
Other Resource | October 2015
FY 2016 Medicare Hospice Payment Reform - Final Policies
This presentation describes the new Medicare hospice payment rules and system updates that states will need to make to comply with the rules. (Centers for Medicare & Medicaid Services)
Brief | August 2010
Cost Drivers for Dually Eligible Beneficiaries: Potentially Avoidable Hospitalizations from Nursing Facility, Skilled Nursing Facility, and Home and Community-Based Services Waiver Programs
This brief focuses on hospitalizations of Medicare-Medicaid beneficiaries who receive long-term care services in nursing facilities, participate in Medicaid home and community-based services waiver programs for the aged or disabled, or receive post-… (Centers for Medicare & Medicaid Services)