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 resource was updated in June 2023 to correct an error in the definition of applicable integrated plan in the previous version.
Dual Eligible Special Needs Plans (D-SNPs) must hold contracts with state Medicaid agencies, and states can use… (Integrated Care Resource Center)
This State Medicaid Director Letter invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial… (Centers for Medicare & Medicaid Services)
This State Medicaid Director Letter highlights ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid. These opportunities, which do not require demonstration authority or Medicare waivers, fall into… (Centers for Medicare & Medicaid Services)
This brief highlights insights from states that are fine-tuning their integrated care programsandcan help other states design their own integrated care programs to meet beneficiaryneeds.
(Center for Health Care Strategies)
This brief provides an overview of four integration models: (1) Dual Eligible Special Needs Plan-based; (2) Financial Alignment Initiative-based; (3) the Program of All-Inclusive Care for the Elderly; and (4) accountable care organizations and… (Center for Health Care Strategies)
This resource center gives states tools for developing or refining rate-setting methods for Medicaid managed long-term services and supports (MLTSS) or Medicare-Medicaid integrated care programs.
(Center for Health Care Strategies)
This webinar features an overview of MLTSS rate setting basics, shares initial findings from a project on Medicaid MLTSS rate setting, and also includes a facilitated discussion with an expert actuary and state representatives from Tennessee and… (Integrated Care Resource Center)
This brief examines considerations for rate setting in Medicaid managed long-term services and supports (MLTSS) programs and spotlights the experiences of eight statesin establishing MLTSS payment rates.
(Center for Health Care Strategies)
This brief highlights best practices in disease management/care management programs and considers ways in which states can incorporate them into integrated care models like CMS’ Financial Alignment Initiative for Medicare-Medicaid… (Integrated Care Resource Center)
This presentation describes the objectives of the rate setting process, basic approach, rate structure, and risk mitigation strategies and provides state examples.
(Integrated Care Resource Center)
This brief discusses strategies for structuring rates for managed long-term services and supports programs to encourage the use of home- and community-based services and details states experiences in setting rates for these programs.
(Center for Health Care Strategies)
This brief describes nine core program elements that are critical for achieving high-quality, patient-centered, and cost-effective care for dually eligible beneficiaries.
(Center for Health Care Strategies)