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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 23

Other Resource | June 2024
Lessons Learned from Dual Eligible Special Needs Plans Enrollee Advisory Committee Strategic Conversation
This memorandum outlines lessons learned from a series of strategic conversations the Centers for Medicare & Medicaid Services held with Medicare Advantage organizations in December 2023 and January 2024 regarding calendar year 2023… (Centers for Medicare & Medicaid Services)
Other Resource | August 2022
Guidance for States Seeking to Leverage New Opportunities for Integrated Care Programs
This memorandum provides states with guidance on the process for working with the Centers for Medicare & Medicaid Services (CMS) to establish Dual Eligible Special Needs Plans (D-SNP)-only contracts and develop integrated materials. The Contract… (Centers for Medicare & Medicaid Services)
Webinars and Trainings, Working with Medicare | July 2021
Medicare and Medicaid Nursing Facility Benefits: The Basics and Options for Improved Coordination and Quality
Other Resource | May 2020
Updated Guidance for Medicare Advantage Organizations
This memo provides answers to questions related to two CMS memos released on April 21 and April 23 for Medicare Advantage and Part D plans (including D-SNPs and Medicare-Medicaid Plans (MMPs)) describing guidance for plans related to the COVID-… (Centers for Medicare & Medicaid Services)
Other Resource | April 2020
Updated Guidance for Medicare Advantage Organizations
This memo provides updated information related to previously issued April 21, 2020 guidance, "Information Related to Cronavirus Disease 2019 - COVID-19." (Centers for Medicare & Medicaid Services)
Other Resource | April 2020
Announcement of Calendar Year (CY) 2021 Medicare Advantage (MA) Capitation Rates and Part C and D Payment Policies
This memo describes the annual capitation rate for each Medicare Advantage payment area for CY 2021 and the risk and other factors to be used in adjusting these rates. (Centers for Medicare & Medicaid Services)
Other Resource | April 2020
Updated CMS Processes for Dual Eligible Special Needs Plan (D-SNP) Implementing CY 2021 Medicare-Medicaid Integration and Unified Appeals and Grievance Requirements in Response to Coronavirus Disease 2019 (COVID-19)
In response to the unique circumstances resulting from D-SNPs’ and states’ priority focus on reducing the risks of COVID-19 transmission and maintaining continuity of operations, this memorandum outlines updated CMS processes for review and approval… (Centers for Medicare & Medicaid Services)
Other Resource | January 2020
Additional Guidance on CY 2021 Medicare-Medicaid Integration Requirements for Dual Eligible Special Needs Plans (D-SNPs)
This HPMS memo provides additional guidance and clarification on four topics related to new integration standards for Dual Eligible Special Needs Plans: (1) distinctions between fully integrated D-SNPs (FIDE SNPs) and highly integrated (… (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 | February 2018
Preventing Improper Billing of Medicare-Medicaid Enrollees in Managed Care: Strategies for States and Dual Eligible Special Needs Plans
This brief describes the ongoing problem of improper billing of protected dually eligible beneficiaries for Medicare cost-sharing and describes steps states and health plans can take to address it. (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)
Brief | January 2016
Interdisciplinary Care Teams for Medicare-Medicaid Enrollees: Considerations for States
This brief describes key considerations for developing interdisciplinary care teams and explores how eight states addressed issues such as engaging providers and measurement approaches. (Center for Health Care Strategies)
Brief | January 2016
Communicating Early Results of Integrated Care Efforts for Dually Eligible Individuals: State Approaches
This brief describes approaches that states have used to communicate early integrated care program results. Strategies discussed include developing program indicator dashboards, disseminating beneficiary experience data, and sharing success stories. (Center for Health Care Strategies)
Study Hall Call | December 2015
Provider Engagement and Incentives in Care Management
This presentation features promising practices for information sharing and building relationships between providers, plans, and the state of Minnesota to optimize care management. (Integrated Care Resource Center)