Search for Resources

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.

Displaying 1 - 15 of 24

Other Resource | March 2020
Information for PACE Organizations Regarding Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19)
This memo provides information to PACE organizations to help control and prevent the spread of the virus to causes COVID-19. (Centers for Medicare & Medicaid Services)
Other Resource | July 2019
States’ Medicaid Fee-for-Service Durable Medical Equipment Payment Policies
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)
Other Resource | May 2019
Medicare and Medicaid Programs; Programs of All-Inclusive Care for the Elderly (PACE)
This Centers for Medicare & Medicaid Services (CMS) final rule strengthens patient protections, improves care coordination, and provides administrative flexibilities and regulatory relief for Programs of All-Inclusive Care for the… (Centers for Medicare & Medicaid Services)
Other Resource | January 2019
Strategies to Support Dually Eligible Individuals’ Access to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
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)
Brief | November 2018
Building a Stronger Foundation for Medicare- Medicaid Integration: Opportunities in Modifying State Administrative Processes
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)
Brief | September 2018
Serving Adults with Serious Mental Illness in the Program of All-Inclusive Care for the Elderly: Promising Practices
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)
Brief | June 2018
Facilitating Access to Medicaid Durable Medical Equipment for Dually Eligible Beneficiaries in the Fee-for-Service System: Three State Approaches
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)
Brief | February 2018
Preventing Improper Billing of Medicare-Medicaid Enrollees in Managed Care: Strategies for States and Dual Eligible Special Needs Plans
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)
Brief | January 2016
Interdisciplinary Care Teams for Medicare-Medicaid Enrollees: Considerations for States
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)
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)
Study Hall Call | December 2015
Provider Engagement and Incentives in Care Management
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)
Brief | November 2015
Medicare Chronic Care Management Services Payment: Implications for States Serving Dually Eligible Individuals
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)
Brief | September 2015
Engaging Providers in Integrated Care Programs for Medicare-Medicaid Enrollees: Tips for States
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)
May 2015
Report to Congress: The Centers for Medicare & Medicaid Services' Evaluation of For-Profit PACE Programs under Section 4804(b) of the Balanced Budget Act of 1997
This report presents information on the frailty level, access to care, and the quality of care of PACE participants enrolled with for-profit PACE organizations as compared to not-for-profit PACE organizations and is based on the <a href="… (Centers for Medicare & Medicaid Services)
March 2015
Effect of PACE on Costs, Nursing Home Admissions, and Mortality: 2006-2011
This report examines the effects of PACE on Medicare and Medicaid expenditures, use of nursing facility use, and mortality. (Assistant Secretary for Planning and Evaluation)