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 paper gives an overview of the proposals submitted by states to test two models to align Medicare and Medicaid benefits and financing for dually eligible beneficiaries with the goal of delivering better coordinated care and reducing costs.
(Kaiser Family Foundation)
This policy brief describes the capitated financial alignment demonstration model, including information on financing, enrollment, provider network adequacy, medical necessity determinations, appeals, and quality and oversight.
(Kaiser Family Foundation)
This memo provides guidance to organizations interested in offering capitated financial alignment demonstration plans.
(Centers for Medicare & Medicaid Services)
This presentation explores options for integrating physical and behavioral health services within coordinated delivery systems and how three states - Arizona, Tennessee, and Vermont - are approaching integration from different vantage points.
(Center for Health Care Strategies)
This brief explores state options for integrating physical and behavioral health services within managed delivery systems, including examples of current state programs and critical considerations for implementation.
(Centers for Medicare & Medicaid Services)
This toolkit contains resources addressing strategies for identification, stratification, integration, consumer engagement, information exchange, and financial alignment linked to physical/behavioral health integration.
(Center for Health Care Strategies)
This web-based integrated care plan, developed for the Southwestern Pennsylvania Rethinking Care Program pilot, allows physical and behavioral health plans to share data with care managers.
(UPMC Health Plan)
These documents, including California's proposal, three-way contract, readiness review tool, and evaluation design plan, are posted on the Medicare-Medicaid Coordination Office's website.
(Centers for Medicare & Medicaid Services)
This website provides information on the Medicare-Medicaid Alignment Initiative -- the capitated model Financial Alignment Initiative in Illinois.
(Illinois Department of Healthcare and Family Services)
The CalDuals website provides information on Cal MediConnect -- the capitated model Financial Alignment Initiative in California.
(California Department of Health Care Services)