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 report describes early implementation activities occurring in the first six months of the seven financial alignment demonstrations launched as of May 1, 2014.
(RTI International)
This brief describes the design of the Financial Alignment Initiative and compares key provisions of the 10 capitated model demonstrations. Separate fact sheets are available on each of the 10 demonstrations.
(Medicaid and CHIP Payment and Access Commission)
This brief examines how star rating are calculated and considerations around how differences among beneficiary populations should be recognized.
(National Health Policy Forum)
This webinar explores Medicare Advantage plans' experience with the Star Ratings system, considers whether the system has served to drive quality improvement, how accurately it reflects plan management of quality and service, and what might… (National Health Policy Forum)
This report describes beneficiary experiences with enrollment processes, communication about the model of care, and understanding of care coordination services under the capitated model financial alignment demonstrations.
(Medicaid and CHIP Payment and Access Commission)
This brief explores opportunities for states to develop an integrated appeals process, whether through a D-SNP or a financial alignment demonstration.
(Center for Health Care Strategies)
This webinar summarizes a discussion among states, the Centers for Medicare & Medicaid Services, the National Association of Medicaid Directors, and ICRC about Medicare Advantage Dual Eligible Special Needs Plan contract oversight and quality… (Integrated Care Resource Center)
This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC about Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) contract oversight and quality monitoring procedures.
(Integrated Care Resource Center)
This brief reviews the quality measures chosen by eight states taking part in CMS' capitated model financial alignment demonstrations as of December 2013.
(The Commonwealth Fund)
In this presentation, CMS and MassHealth staff provide different perspectives on the challenges and successes of the three-way contracting process in Massachusetts, including discussion of managing timeframes and interacting with health plans.
(Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to consumer protection including marketing, member materials and education, continuity of care, and grievance and appeals processes.
(Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to care coordination including the structure of the care team, development of care plans, caseload requirements, and use of a centralized enrollee record.
(Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to behavioral health including coordination of behavioral health services, network availability of behavioral health services, and inclusion of behavioral health… (Integrated Care Resource Center)