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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 31

Tip Sheet | June 2023
Definitions of Different Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) Types in 2023 and 2025
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)
Webinars and Trainings, Working with Medicare | July 2021
Medicare and Medicaid Nursing Facility Benefits: The Basics and Options for Improved Coordination and Quality
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 2019
Three New Opportunities to Test Innovative Models of Integrated Care for Individuals Dually Eligible for Medicaid and Medicare
This State Medicaid Director Letter invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial… (Centers for Medicare & Medicaid Services)
Other Resource | December 2018
Ten Opportunities to Better Serve Individuals Dually Eligible for Medicaid and Medicare
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)
Other Resource | December 2018
Nursing Facility Case-Mix Payment Changes Informational Bulletin
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)
Study Hall Call | July 2018
Using Value Based Purchasing (VBP) Arrangements to Improve Coordination and Quality of Medicare and Medicaid Nursing Facility Benefits
This webinar provides an overview of two health plans' approaches to Medicare-Medicaid value based purchasing (VBP) with nursing facilities. The presentation also features a panel discussion on Medicare-Medicaid nursing facility VBP with discussants… (Integrated Care Resource Center)
Brief | September 2017
Value-Based Payment in Nursing Facilities: Options and Lessons for States and Managed Care Plans
This brief describes value-based payment approaches currently used in select states and managed care plans, including the quality and performance measures they use, benchmarks or targets for those measures, and incentives that reward facilities. It… (Integrated Care Resource Center)
June 2017
Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers
This third edition of the scorecard measures state performance in creating a high-quality system of care for older adults and people with physical disabilities, and their family caregivers. The report presents results across five dimensions: (1)… (AARP Public Policy Institute)
Brief | December 2016
State Insights on Refining Integrated Care for Dually Eligible Beneficiaries
This brief highlights insights from states that are fine-tuning their integrated care programsandcan help other states design their own integrated care programs to meet beneficiaryneeds. (Center for Health Care Strategies)
Brief | December 2016
Snapshot of Integrated Care Models to Serve Dually Eligible Beneficiaries
This brief provides an overview of four integration models: (1) Dual Eligible Special Needs Plan-based; (2) Financial Alignment Initiative-based; (3) the Program of All-Inclusive Care for the Elderly; and (4) accountable care organizations and… (Center for Health Care Strategies)
March 2016
Medicaid Managed Long-Term Services and Supports: Themes from Site Visits to Five States
During site visits to five states (Arizona, Florida, Illinois, New York, and Wisconsin), researchers identified major themes related to the rapid growth of Medicaid managed long-term services and supports (MLTSS) programs and the diversity of ways… (Mathematica)
Study Hall Call | July 2015
Building State, Health Plan and Nursing Facility Relationships in Integrated Medicare-Medicaid Programs
This presentation discusses successful approaches to building collaborative working relationships between states, health plans, and nursing facility providers in integrated Medicare-Medicaid programs (Integrated Care Resource Center)
Study Hall Call | June 2015
Reducing Avoidable Hospitalizations Among Nursing Facility Residents: Three Perspectives
The webinar features perspectives and lessons learned from two Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs) - HealthPartners in Minnesota and Bridgeway Health Solutions in Arizona - and from The Curators of the University of… (Integrated Care Resource Center)
Brief | April 2015
Reducing Avoidable Hospitalizations for Medicare-Medicaid Enrollees in Nursing Facilities: Issues and Options for States
This brief outlines the options available to states in both capitated and fee-for-service arrangements to reduce avoidable hospitalizations from nursing facilities. (Integrated Care Resource Center)