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)
Dual Eligible Special Needs Plans (D-SNPs) must develop a model of care (MOC) that describes their enrollees’ characteristics and health and service needs as well as the plan’s care coordination and health risk assessment processes. Despite the… (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 MACPAC report reviews and analyzes care coordination requirements in the managed care organization contracts of nine states participating in demonstrations under the Financial Alignment Initiative, 10 states that contract with Fully Integrated… (Medicaid and CHIP Payment and Access Commission)
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 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)
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)
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)
This brief explores how health plans are: (1) addressing dually eligible members’ service needs that are beyond the scope of traditionally covered Medicare or Medicaid services; (2) assessing the value of offering these services; and (3)… (Center for Health Care Strategies)
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 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)
This brief identifies opportunities for states and their contracting plans that serve Medicare-Medicaid enrollees to better align Medicare and Medicaid coverage of care management using Medicare's new chronic care management payment.
(Integrated Care Resource Center)
This report summarizes care coordination models and care coordinator responsibilities in Medicaid managed long-term services and supports programs in 18 states.
(AARP Public Policy Institute)