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 brief provides suggestions for designing and implementing integrated care initiatives that are of high quality, offer attractive benefits and services, and provide easy-to-understand education, outreach, and marketing information. It also… (Integrated Care Resource Center)
This brief examines key policy and operational considerations related to the transition from fee-for-service to risk-based capitated managed care for LTSS.
(Kaiser Family Foundation)
This technical assistance tool provides states with options to evaluate health plans' past performance as they consider those plans for participation in their integrated Medicare-Medicaid programs.
(Integrated Care Resource Center)
This brief provides basic information on Medicare Part D, including how beneficiaries are enrolled in Part D, how Part D drugs are paid for, what drugs are and are not covered in Part D, how drug utilization is managed in Part D, and how the Part D… (Integrated Care Resource Center)
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 reviews primary care case management and related models to gather insights into key program design elements in managed fee-for-service models.
(Integrated Care Resource Center)
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)