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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 - 15 of 16

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)
Technical Assistance Tool | July 2019
Using Default Enrollment to Align Coverage for Dually Eligible Medicare-Medicaid Beneficiaries
This fact sheet, updated in July 2019, summarizes default enrollment requirements and state roles in the default enrollment approval and implementation process. It also provides references to additional resources for more detail and… (Integrated Care Resource Center)
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)
Other Resource | February 2019
Default Enrollment FAQs
This resource is an FAQ document detailing a number of commonly asked questions regarding default enrollment. (Medicare-Medicaid Coordination Office)
Other Resource | October 2018
Default Enrollment Model Notice
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)
Study Hall Call | July 2018
Aligning Coverage for Dually Eligible Beneficiaries Using Default and Passive Enrollment
This webinar provides a history of seamless conversion and describes the new process for default enrollment that will start in 2019. This webinar also explains states’ roles in this process, including the need to identify beneficiaries newly… (Integrated Care Resource Center)
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)
Study Hall Call | January 2015
Building and Validating LTSS Provider Networks
This presentation examines strategies for states establishing Medicaid MLTSS or integrated care programs to ensure that health plans develop LTSS provider networks to address beneficiaries' diverse needs. (Integrated Care Resource Center)
Other Resource | July 2014
Identifying Community-Based Resources: Key Considerations for Health Plans
This fact sheet for health plans lists community-based resources and how they may help to address the needs of Medicare-Medicaid enrollees. (Resources for Integrated Care)
Other Resource | January 2014
Medicare Advantage Network Adequacy Requirements, D-SNPs, and State Contracting Options
This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage network adequacy requirements and their application to D-SNPs. (Integrated Care Resource Center)
Other Resource | December 2013
Ready, Set, Go! The Readiness Review Process for Care Coordination and Provider Network Adequacy in Five States
This report spotlights the approaches used by five states - Arizona, Minnesota, Tennessee, Texas, and Wisconsin - to ensure managed care organizations are ready to provide care coordination services to consumers and adequate access to needed long-… (AARP Public Policy Institute)
Brief | July 2013
Developing Provider Networks for Medicaid Managed Long-Term Services and Supports Programs: Considerations for States
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)
May 2013
Transitioning Long Term Services and Supports Providers Into Managed Care Programs
This paper identifies concerns and considerations in incorporating traditional LTSS providers into a managed care program. (Truven Health Analytics)