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.
Concerns about care transitions between acute and long-term services and supports (LTSS) settings have been raised since at least the 1990s. More recently, studies have emphasized the growing need to address care transitions from nursing homes to… (AARP Public Policy Institute)
The Community-Based Care Transitions Program (CCTP) supported by the CMS Center for Medicare & Medicaid Innovation tests models for improving care transitions from the hospital to other settings and reducing readmissions for high-risk Medicare… (Centers for Medicare & Medicaid Services)
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 outlines the options available to states in both capitated and fee-for-service arrangements to reduce avoidable hospitalizations from nursing facilities.
(Integrated Care Resource Center)
This brief shares strategies for hiring and training care managers for health plans with integrated care programs serving Medicare-Medicaid beneficiaries.
(Center for Health Care Strategies)
This webinar for California's Medi-Cal health plans highlights strategies for hiring and training care managers in integrated care programs.
(Center for Health Care Strategies)
This webinar shares health plan strategies for contacting hard-to-locate Medicare-Medicaid enrollees, building relationships, and creating person-centered care plans that incorporate social service and housing needs.
(Center for Health Care Strategies)
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 brief describes how three states - California, Ohio, and Virginia - are requiring Medicare-Medicaid Plans to stratify Medicare-Medicaid enrollees by their level of need within capitated financial alignment demonstrations.
(Center for Health Care Strategies)
This presentation describes the approach of health plans in Arizona and Minnesota to managing care transitions by Medicare-Medicaid enrollees and other beneficiaries with complex conditions.
(Integrated Care Resource Center)
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)