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.
To better inform analysis of existing policies and development of future policies that affect Medicaid payments, the Medicaid and CHIP Payment and Access Commission (MACPAC) released a compendium of each state’s fee-forservice DME policies along… (Medicaid and CHIP Payment and Access Commission)
This Centers for Medicare & Medicaid Services (CMS) Informational Bulletin provides an additional strategy for states to support timely access to durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) for people dually eligible… (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)
Program of All-Inclusive Care for the Elderly (PACE) organizations now serve a greater number of older adults with serious mental illness (SMI) than ever before, and increasingly include behavioral health providers in their care teams to meet the… (Center for Health Care Strategies)
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 brief describes the ongoing problem of improper billing of protected dually eligible beneficiaries for Medicare cost-sharing and describes steps states and health plans can take to address it.
(Integrated Care Resource Center)
This brief explores the experience of six states that have achieved varying levels of behavioral health and physical health integration or collaboration for dually eligible beneficiaries within a managed care environment. It describes: (1)… (Integrated Care Resource Center)
This brief describes how innovative states and Medicaid managed care organizations are building on models developed for physical health services and incorporating value-based purchasing arrangements into behavioral health programs.
(Center for Health Care Strategies)
This brief describes Commonwealth Care Alliance's development of enhanced residential crisis stabilization units that fill a gap in the behavioral health continuum of care available to enrollees in Massachusetts' Medicare-Medicaid… (Integrated Care Resource Center)
This chapter discusses the approaches used by the Financial Alignment Initiative demonstrations, Medicare Advantage Dual Eligible Special Needs Plans, and the Program of All-inclusive Care for the Elderly to integrate behavioral health and physical… (Medicaid and CHIP Payment and Access Commission)
This brief describes key considerations for developing interdisciplinary care teams and explores how eight states addressed issues such as engaging providers and measurement approaches.
(Center for Health Care Strategies)
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)
This presentation features promising practices for information sharing and building relationships between providers, plans, and the state of Minnesota to optimize care management.
(Integrated Care Resource Center)
This brief identifies opportunities for states and their contracting plans that serve Medicare-Medicaid enrollees to better align Medicare and Medicaid coverage of care management using Medicare's new chronic care management payment.
(Integrated Care Resource Center)
This brief offers tips to states on engaging a range of providers who serve Medicare-Medicaid enrollees in managed care systems and provides examples of approaches employed by states that have already launched integrated care programs.
(Integrated Care Resource Center)