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 informational bulletin informs states of two changes that may impact states’ payments for Medicaid beneficiaries in the nursing home setting.
(Centers for Medicare & Medicaid Services)
This brief describes several administrative changes that state Medicaid programs can make to: (1) support integration efforts; (2) improve beneficiaries’ experience of care; (3) decrease beneficiary out-of-pocket costs; and (4) reduce provider… (Integrated Care Resource Center)
This webinar provides background on the technical operations updates to Medicare enrollment transactions and processing for dually eligible beneficiaries related to the changes from the Medicare Part C/D final rule released on April 2, 2018. The… (Integrated Care Resource Center)
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)
This brief describes how three states – California, Connecticut, and Illinois -- promote dually eligible beneficiaries’ access to durable medical equipment (DME) in a fee-for-service environment through the use of provisional prior authorization… (Integrated Care Resource Center)
This webinar discusses strategies to increase and sustain enrollment into Medicare-Medicaid Plans, including on-going passive enrollment of newly dually eligible individuals and deeming and rapid-re-enrollment strategies to retain coverage for short… (Integrated Care Resource Center)
This webinar describes the retroactive submission process, including how to use CMS' Electronic Retroactive Processing Transmission (eRPT) application to transmit enrollment transactions to the Retroactive Processing Contractor.
(Integrated Care Resource Center)
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)
This document answers questions that states have asked about improving the processes they use to regularly identify prospective Medicare-Medicaid individuals for potential enrollment into their capitated financial alignment demonstrations.
(Integrated Care Resource Center)
This technical assistance tool lists questions frequently asked by beneficiaries enrolling in capitated Financial Alignment Initiative demonstrations, and provides potential responses by enrollment brokers' customer service representatives (… (Integrated Care Resource Center)
This webinar describes an opportunity identify prospective Medicare-Medicaid enrollees for enrollment into capitated financial alignment demonstrations and provides perspectives from Massachusetts and Michigan on states' use of this process.… (Integrated Care Resource Center)
This webinar features state experiences using data-driven strategies to analyze opt-outs and engage beneficiaries and providers in financial alignment demonstrations.
(Integrated Care Resource Center)
This document describes the process that states and health plans participating in the capitated financial alignment demonstrations use to submit information to CMS' MARx systems.
(Centers for Medicare & Medicaid Services)
This presentation introduces state enrollment staff to a tool to help prioritize transaction reply codes and simplify enrollment reconciliation.
(Integrated Care Resource Center)
This document describes a Microsoft Access tool to prioritize information in the MARx system Daily Transaction Reply Report, and it explains states can use it to improve the timeliness and efficiency of their demonstration enrollment processes.
(Integrated Care Resource Center)