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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 40

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)
Webinars and Trainings | November 2023
Improving Quality and Performance in Dual Eligible Special Need Plans (D-SNPs): Monitoring and Oversight Tips for States
This webinar describes the Medicare resources available to states to monitor D-SNP performance and provide tips for states on incorporating D-SNPs into Medicaid quality improvement activities. Learning Objectives: By the end of this… (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)
Study Hall Call | July 2018
Aligning Coverage for Dually Eligible Beneficiaries Using Default and Passive Enrollment
This webinar provides a history of seamless conversion and describes the new process for default enrollment that will start in 2019. This webinar also explains states’ roles in this process, including the need to identify beneficiaries newly… (Integrated Care Resource Center)
Tip Sheet | June 2018
Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Using Medicare Program Audit Reports to Improve Managed Care Organization Oversight
This tip sheet describes how states can use the results of Medicare program audits to identify performance issues impacting dually eligible beneficiaries’ receipt of care coordination, long-term services and supports, durable medical equipment… (Integrated Care Resource Center)
Tip Sheet | April 2018
Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Promoting Aligned Enrollment
This tip sheet outlines tips for promoting aligned enrollment in states looking to integrate care for dually eligible beneficiaries using contracting strategies that maximize the opportunity for Medicare Advantage Dual Eligible Special Needs… (Integrated Care Resource Center)
Study Hall Call | March 2018
Partnering with SHIPs to Improve Care
This webinar provides an overview of partnerships between Medicaid agencies and SHIPs in both PA and SC. (Integrated Care Resource Center)
Technical Assistance Tool | January 2018
How States Can Monitor Dual Eligible Special Needs Plan Performance: A Guide to Using CMS Data Resources
This resource shows how states can use data from the Centers of Medicare and Medicaid to create tables, graphs, and figures and interpret their meaning in order to assess D-SNP performance. (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)
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)
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 | May 2015
State Use of Medicare Advantage Encounter Data: Perspectives from Two States
Provides an overview of how state Medicaid agencies can obtain and use Medicare Advantage encounter data and shares insights from Arizona's and Tennessee's experiences with this process. (Integrated Care Resource Center)
Brief | May 2015
The Star Rating System and Medicare Advantage Plans
This brief examines how star rating are calculated and considerations around how differences among beneficiary populations should be recognized. (National Health Policy Forum)