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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 30

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)
Brief | March 2021
State Approaches to Developing and Operating Ombudsman Programs for Demonstrations under the Financial Alignment Initiative
Ombudsman programs can offer beneficiary protections as part of Medicaid managed care programs. These programs are particularly important for beneficiaries with complex physical and behavioral health conditions, including many dually eligible… (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
Information for PACE Organizations Regarding Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19)
This memo provides information to PACE organizations to help control and prevent the spread of the virus to causes COVID-19. (Centers for Medicare & Medicaid Services)
Other Resource | May 2019
Medicare and Medicaid Programs; Programs of All-Inclusive Care for the Elderly (PACE)
This Centers for Medicare & Medicaid Services (CMS) final rule strengthens patient protections, improves care coordination, and provides administrative flexibilities and regulatory relief for Programs of All-Inclusive Care for the… (Centers for Medicare & Medicaid Services)
Brief | January 2019
An Exploration of Consumer Advisory Councils within Medicare-Medicaid Plans Participating in the Financial Alignment Initiative
The Center for Consumer Engagement in Health Innovation released a report The Biggest Value is Getting the Voice of the Member describing its findings on the composition, function, and impact of the Consumer Advisory Councils operating within… (Center for Consumer Engagement in Health Innovation)
Brief | September 2018
Serving Adults with Serious Mental Illness in the Program of All-Inclusive Care for the Elderly: Promising Practices
Program of All-Inclusive Care for the Elderly (PACE) organizations now serve a greater number of older adults with serious mental illness (SMI) than ever before, and increasingly include behavioral health providers in their care teams to meet the… (Center for Health Care Strategies)
Study Hall Call | July 2018
Building Relationships between Managed Care Organizations and Beneficiary Ombudsman Programs
This webinar highlights the importance of beneficiary ombudsman programs and provides an overview of available supports, including Medicare resources and state programs that provide assistance to dually eligible beneficiaries. Representatives from… (Integrated Care Resource Center)
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)
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)
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 | July 2017
Medicaid Agency Partnerships with State Health Insurance Programs: Opportunities to Improve Care for Medicare-Medicaid Enrollees
This brief describes opportunities for Medicaid agencies to partner with State Health Insurance Assistance Programs (SHIPs) in educating Medicare-Medicaid enrollees and their families on new integrated care program options. (Integrated Care Resource Center)
December 2016
Report to Congress: Social Risk Factors and Performance Under Medicare's Value-Based Purchasing Programs
This report, mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 ("IMPACT Act"), details research conducted on the relationships between social rick factors and performance in Medicare's value-based… (Office of the Assistant Secretary for Planning and Evaluation [ASPE])
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)
May 2015
Report to Congress: The Centers for Medicare & Medicaid Services' Evaluation of For-Profit PACE Programs under Section 4804(b) of the Balanced Budget Act of 1997
This report presents information on the frailty level, access to care, and the quality of care of PACE participants enrolled with for-profit PACE organizations as compared to not-for-profit PACE organizations and is based on the <a href="… (Centers for Medicare & Medicaid Services)