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 report examines how five states have structured the interface between MFP demonstration grants and Managed long-term services and supports (MLTSS) programs to promote transitions from institutional care to home- and community-based settings.
(Mathematica)
This report provides an overview of LTSS, the risks and benefits of Medicaid MLTSS, policy recommendations and promising practices from states that have implemented these programs.
(Community Catalyst)
This background paper examines the contents of states' proposals in the areas of target population, implementation date, enrollment, financing, benefits, beneficiary protections, stakeholder engagement, and demonstration evaluation.
(Kaiser Family Foundation)
This paper gives an overview of the proposals submitted by states to test two models to align Medicare and Medicaid benefits and financing for dually eligible beneficiaries with the goal of delivering better coordinated care and reducing costs.
(Kaiser Family Foundation)
This chart lists the population groups that are enrolled in current MLTSS programs, as well as those projected to be enrolled in future MLTSS programs.
(Truven Health Analytics)
This policy brief describes the capitated financial alignment demonstration model, including information on financing, enrollment, provider network adequacy, medical necessity determinations, appeals, and quality and oversight.
(Kaiser Family Foundation)
This brief examines issues in the development and implementation of managed care programs for Medicaid beneficiaries with disabilities, particularly policy considerations related to setting rates, developing provider networks and delivery systems,… (Kaiser Family Foundation)
This document articulates guiding principles that should be observed in designing and carrying out managed care initiatives involving people with chronic disabilities.
(National Council on Disability)
This document assesses the impact of managed care on people with disabilities to identify the opportunities/risks and strengths/weaknesses of pursuing managed care as a component of health care reform.
(National Council on Disability)
This memo provides guidance to organizations interested in offering capitated financial alignment demonstration plans.
(Centers for Medicare & Medicaid Services)
This website provides information on the Medicare-Medicaid Alignment Initiative -- the capitated model Financial Alignment Initiative in Illinois.
(Illinois Department of Healthcare and Family Services)
The CalDuals website provides information on Cal MediConnect -- the capitated model Financial Alignment Initiative in California.
(California Department of Health Care Services)
These documents, including California's proposal, three-way contract, readiness review tool, and evaluation design plan, are posted on the Medicare-Medicaid Coordination Office's website.
(Centers for Medicare & Medicaid Services)