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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 39

Tip Sheet | February 2024
Integrating Dual Eligible Special Needs Plan Materials to Promote Enrollee Understanding of and Access to Benefits
Integrating Dual Eligible Special Needs Plan Materials to Promote Enrollee Understanding of and Access to Benefits Dual Eligible Special Needs Plans (D-SNPs) that operate with exclusively aligned enrollment and cover Medicaid benefits through the D-… (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 | May 2020
Contract Year 2021 Models for Applicable Integrated Plans: 'Letter about Your Right to Make a Fast Complaint' and 'Appeal Decision Letter'
This CMS memorandum describes the final Contract Year 2021 model notices for Dual Eligible Special Needs Plans that are applicable integrated plans, "Letter about Your Right to Make a Fast Complaint" and "Appeal Decision Letter", which are both… (Centers for Medicare & Medicaid Services)
February 2019
CY 2019 MN MSHO Summary of Benefits (SB) model document
(Centers for Medicare & Medicaid Services/Minnesota Department of Human Services)
Brief | September 2018
Serving Adults with Serious Mental Illness in the Program of All-Inclusive Care for the Elderly: Promising Practices
Program of All-Inclusive Care for the Elderly (PACE) organizations now serve a greater number of older adults with serious mental illness (SMI) than ever before, and increasingly include behavioral health providers in their care teams to meet the… (Center for Health Care Strategies)
Tip Sheet | June 2018
Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Designing an Integrated Summary of Benefits Document
This tip sheet describes how states can start to improve member materials by using contractual requirements to ensure that Medicare and Medicaid benefit information for aligned plans is incorporated into a single, streamlined Summary of… (Integrated Care Resource Center)
Brief | August 2017
Integrating Behavioral and Physical Health for Medicare-Medicaid Enrollees: Lessons for States Working With Managed Care Delivery Systems
This brief explores the experience of six states that have achieved varying levels of behavioral health and physical health integration or collaboration for dually eligible beneficiaries within a managed care environment. It describes: (1)… (Integrated Care Resource Center)
Brief | June 2017
State and Health Plan Strategies to Grow Enrollment in Integrated Managed Care Plans for Dually Eligible Beneficiaries
This brief outlines a variety of actions that states and health plans can take to support enrollment growth in integrated care programs. (Integrated Care Resource Center)
Brief | June 2017
Moving Toward Value-Based Payment for Medicaid Behavioral Health Services
This brief describes how innovative states and Medicaid managed care organizations are building on models developed for physical health services and incorporating value-based purchasing arrangements into behavioral health programs. (Center for Health Care Strategies)
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 | May 2016
Alternatives to Inpatient Psychiatric Services for Medicare-Medicaid Enrollees: A Case Study of Commonwealth Care Alliance
This brief describes Commonwealth Care Alliance's development of enhanced residential crisis stabilization units that fill a gap in the behavioral health continuum of care available to enrollees in Massachusetts' Medicare-Medicaid… (Integrated Care Resource Center)
Other Resource | March 2016
Report to Congress on Medicaid and CHIP - Chapter 4: Integration of Behavioral and Physical Health Services in Medicaid
This chapter discusses the approaches used by the Financial Alignment Initiative demonstrations, Medicare Advantage Dual Eligible Special Needs Plans, and the Program of All-inclusive Care for the Elderly to integrate behavioral health and physical… (Medicaid and CHIP Payment and Access Commission)
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)
February 2015
Rebalancing in Capitated Medicaid Managed Long-Term Services and Supports Programs: Key Issues from a Roundtable Discussion on Measuring Performance
This document summarizes key discussions during a roundtable with a group of federal and state officials and other experts on issues related to how rebalancing progress in capitated Medicaid MLTSS programs is measured. (Kaiser Family Foundation)
February 2015
Measuring Long-Term Services and Supports Rebalancing
This fact sheet provides an overview of quality measures related to the rebalancing of long-term services and supports. (Kaiser Family Foundation)