Search for Resources

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 23

Webinars and Trainings | February 2025
Quality Improvement for D-SNP Enrollees Using Behavioral Health Services or Long-Term Services and Supports (LTSS)
This webinar builds on ICRC’s Fall 2023 introductory D-SNP quality oversight and improvement tip sheet and webinar, focusing on how states can improve the quality of LTSS and behavioral health services. Learning Objectives: By… (Integrated Care Resource Center)
Tip Sheet | October 2024
How States Can Use Medicare Advantage Star Ratings to Assess D-SNP Quality and Performance
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)
Tip Sheet | October 2023
Tips for States on Incorporating D-SNPs into Medicaid Quality Improvement Activities
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)
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)
Webinars and Trainings, Study Hall Call | March 2021
Perspectives on Ombudsman Programs Serving Dually Eligible Individuals: Services Offered and Value Added
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)
Other Resource | March 2020
Reprioritization of PACE, Medicare Parts C and D Program, and Risk Adjustment Data Validation (RACV) Audit Activities
In response to the spread of COVID-19, the Centers for Medicare & Medicaid Services (CMS) has suspended non-emergency federal and state survey agency surveys. Consistent with that action, CMS is reprioritizing scheduled program audits for… (Centers for Medicare & Medicaid Services)
Study Hall Call | April 2019
D-SNP Performance Monitoring and Oversight: State Experiences and CMS Resources
This webinar covers resources and strategies available to states to begin or improve their oversight of Dual Eligible Special Needs Plans (D-SNPs). Presenters provide an overview of the Centers for Medicare & Medicaid Services’ (CMS)… (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)
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)
December 2016
Report to Congress: Social Risk Factors and Performance Under Medicare's Value-Based Purchasing Programs
This report, mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 ("IMPACT Act"), details research conducted on the relationships between social rick factors and performance in Medicare's value-based… (Office of the Assistant Secretary for Planning and Evaluation [ASPE])
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)
June 2016
Accounting for Social Risk Factors in Medicare Payment: Identifying Risk Factors
This report presents a conceptual social risk factor framework, and details the results of a literature review linking social risk factors to health care outcomes important to Medicare payment and quality programs. (National Academies of Sciences, Engineering, and Medicine)
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)
Brief | January 2016
Communicating Early Results of Integrated Care Efforts for Dually Eligible Individuals: State Approaches
This brief describes approaches that states have used to communicate early integrated care program results. Strategies discussed include developing program indicator dashboards, disseminating beneficiary experience data, and sharing success stories. (Center for Health Care Strategies)
Brief | December 2015
Assessing Success in Medicare-Medicaid Integration: A Review of Measurement Strategies
This brief examines the potential of current and planned measures to accurately assess the performance of integrated care programs for dually eligible individuals. (Center for Health Care Strategies)