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 tip sheet summarizes key considerations for states trying to decide which pathway to use to advance Medicare-Medicaid integration, and which Medicaid managed care authority(ies) might best support that pathway. Although the tip sheet presents… (Integrated Care Resource Center)
This report provides data on the characteristics of dually eligible individuals and information on their use of services and costs of care.
(Medicare Payment Advisory Commission)
States may execute a Medicare Part A buy-in agreement with the Centers for Medicare & Medicaid Services (CMS) to facilitate access to Medicare Part A and dual eligible status under the Qualified Medicare Beneficiary (QMB) eligibility group. This… (Integrated Care Resource Center)
States may execute a Medicare Part A buy-in agreement with the Centers for Medicare & Medicaid Services (CMS) to facilitate access to Medicare Part A and dual eligible status under the Qualified Medicare Beneficiary (QMB) eligibility group. This… (Integrated Care Resource Center)
States need to be able to identify individuals who are (or will become) dually eligible for several reasons. Since 2005, states have exchanged files -- known as the Medicare Modernization Act (MMA) files -- with the Centers for Medicare… (Integrated Care Resource Center)
States can advance integrated care for dually eligible individuals by promoting aligned enrollment in Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) and Medicaid managed care plans owned by the same parent company (“affiliated”… (Integrated Care Resource Center)
This webinar describes what Medicare and Medicaid data are publicly available and some simple tools that states can use to begin to explore these data. For states that are ready to undertake more in-depth analyses of Medicare data, the… (Integrated Care Resource Center)
This document provides answers to states' frequently asked questions about Medicare Part A Buy-in. It describes the advantages to states of having a Buy-in agreement and how these agreements can help to promote access to integrated care for dually… (Centers for Medicare & Medicaid Services)
This technical assistance tool shows states how to use data on Medicare-Medicaid dually eligible beneficiary demographics, service utilization, spending, and other characteristics to create tables, graphs, and figures and interpret their meaning for… (Integrated Care Resource Center)
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 document describes the benefits of daily data exchanges with CMS. It also provides technical FAQs on buy-in data exchanges.
(Centers for Medicare & Medicaid Services)
This resource shows how states can use data from the Centers of Medicare and Medicaid to create tables, graphs, and figures and interpret their meaning in order to assess D-SNP performance.
(Integrated Care Resource Center)