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 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 webinar provides an overview of the Administration for Community Living's initiative to improve the business acumen of community-based organizations (CBOs) and features perspectives from a CBO and a health plan on building contractual… (Integrated Care Resource Center)
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 issue brief details four considerations that community-based organizations (CBOs) need to address when assessing the feasibility of participating in a managed long-term services and supports program: (1) relevant skill set and experience; (2)… (National Association of States United for Aging and Disabilities)
This presentation highlights issues with overlapping coverage for home health services and durable medical equipment (DME), and describes the Health Plan of San Mateo's approach to coordinating these services, including operating protocols,… (Integrated Care Resource Center)
This report examines strategies states are using to address or eliminate system-level barriers to integrated care for Medicaid beneficiaries with both physical and behavioral health care needs.
(The Commonwealth Fund)
This fact sheet for health plans lists community-based resources and how they may help to address the needs of Medicare-Medicaid enrollees.
(Resources for Integrated Care)
This brief outlines considerations to guide state Medicaid agencies in successfully integrating behavioral health services within accountable care organizations, including decisions around financial strategies, data sharing, and quality measurement.
(Center for Health Care Strategies)