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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 26

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)
Technical Assistance Tool | July 2019
Using Default Enrollment to Align Coverage for Dually Eligible Medicare-Medicaid Beneficiaries
This fact sheet, updated in July 2019, summarizes default enrollment requirements and state roles in the default enrollment approval and implementation process. It also provides references to additional resources for more detail and… (Integrated Care Resource Center)
Other Resource | February 2019
Default Enrollment FAQs
This resource is an FAQ document detailing a number of commonly asked questions regarding default enrollment. (Medicare-Medicaid Coordination Office)
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)
Other Resource | October 2018
Default Enrollment Model Notice
This resource is a model letter that D-SNPs have the option to use to meet CMS beneficiary notice requirements for default enrollment. All letters used will need to contain the required CMS disclaimers, materials ID and receive appropriate CMS… (Medicare-Medicaid Coordination Office)
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
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)
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 | 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)
August 2016
Managed Long-Term Services and Supports Rate Setting Resource Center
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)
Study Hall Call | March 2016
Overview of State Considerations for Medicaid Managed Long-Term Services and Supports (MLTSS) Rate Setting
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)
Brief | January 2016
Developing Capitation Rates for Medicaid Managed Long-Term Services and Supports Programs: State Considerations
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)
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)