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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.

(-) Capitated Model

Displaying 16 - 30 of 43

Study Hall Call | July 2016
Data-Driven Strategies - Analyzing Opt-Outs and Engaging Beneficiaries and Providers
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)
Other Resource | June 2016
Data-Driven Strategies - Analyzing Opt-Outs and Engaging Beneficiaries and Providers
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)
Study Hall Call | March 2016
Using Microsoft Access to Simplify Enrollment Reconciliation in Capitated Financial Alignment Demonstrations
This presentation introduces state enrollment staff to a tool to help prioritize transaction reply codes and simplify enrollment reconciliation. (Integrated Care Resource Center)
Other Resource | March 2016
Technical Notes on a Microsoft Access Tool for Prioritizing the Daily Transaction Record Report
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)
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)
Technical Assistance Tool | December 2015
Training Enrollment Broker Call Center Staff: Tips for States Implementing Capitated Financial Alignment Demonstrations
This tool describes the key areas of information that demonstration enrollment brokers' customer service representatives should master to improve the quality of decision-support services for beneficiaries who are being passively enrolled in a… (Integrated Care Resource Center)
Other Resource | October 2015
Report on Early Implementation of Demonstrations under the Financial Alignment Initiative
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)
Brief | September 2015
Financial Alignment Initiative for Beneficiaries Dually Eligible for Medicaid and Medicare
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)
Other Resource | May 2015
Experiences with Financial Alignment Initiative Demonstration Projects in Three States: Feedback from Enrollees in California, Massachusetts, and Ohio
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)
Brief | January 2015
Integrated Appeals Processes for Medicare-Medicaid Enrollees: Lessons from States
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)
Webinars and Trainings | October 2013
Three-Way Contracting - The Massachusetts Experience
Study Hall Call | October 2013
Three-Way Contracting - The Massachusetts Experience
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)
Technical Assistance Tool | July 2013
Selected Provisions from Integrated Care RFPs and Contracts: Consumer Protection
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)
Technical Assistance Tool | July 2013
Selected Provisions from Integrated Care RFPs and Contracts: Care Coordination
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)
Technical Assistance Tool | July 2013
Selected Provisions from Integrated Care RFPs and Contracts: Behavioral Health
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)