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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.

Displaying 1 - 15 of 36

Tip Sheet | October 2024
How States Can Use Medicare Advantage Star Ratings to Assess D-SNP Quality and Performance
The Centers for Medicare & Medicaid Services (CMS) uses a five-star quality rating system to evaluate the performance of Medicare Advantage (MA) health plans. This Star Rating system enables beneficiaries, payers, and others to compare plans… (Integrated Care Resource Center)
Webinars and Trainings | November 2023
Improving Quality and Performance in Dual Eligible Special Need Plans (D-SNPs): Monitoring and Oversight Tips for States
This webinar describes the Medicare resources available to states to monitor D-SNP performance and provide tips for states on incorporating D-SNPs into Medicaid quality improvement activities. Learning Objectives: By the end of this… (Integrated Care Resource Center)
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 | March 2020
Reprioritization of PACE, Medicare Parts C and D Program, and Risk Adjustment Data Validation (RACV) Audit Activities
In response to the spread of COVID-19, the Centers for Medicare & Medicaid Services (CMS) has suspended non-emergency federal and state survey agency surveys. Consistent with that action, CMS is reprioritizing scheduled program audits for… (Centers for Medicare & Medicaid Services)
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 | April 2019
Selected Characteristics of 10 States With the Greatest Change in Long-Term Services and Supports System Balancing, 2012–2016
This report provides a national overview of long-term services and supports (LTSS) rebalancing and highlights 10 states – Missouri, Massachusetts, New York, New Jersey, Connecticut, Colorado, South Carolina, Illinois, Nevada, and Arkansas… (Centers for Medicare & Medicaid Services)
Study Hall Call | April 2019
D-SNP Performance Monitoring and Oversight: State Experiences and CMS Resources
This webinar covers resources and strategies available to states to begin or improve their oversight of Dual Eligible Special Needs Plans (D-SNPs). Presenters provide an overview of the Centers for Medicare & Medicaid Services’ (CMS)… (Integrated Care Resource Center)
Study Hall Call | March 2019
New MLTSS Assessment and Care Planning Quality Measures: Implementation Issues for States and Integrated Care Plans
This webinar describes four new quality measures specifically designed for use by Medicaid managed long-term services and supports (MLTSS) plans, which address comprehensive assessments, comprehensive care plans, shared care plans with primary… (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)
Tip Sheet | June 2018
Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Using Medicare Program Audit Reports to Improve Managed Care Organization Oversight
This tip sheet describes how states can use the results of Medicare program audits to identify performance issues impacting dually eligible beneficiaries’ receipt of care coordination, long-term services and supports, durable medical equipment… (Integrated Care Resource Center)
Technical Assistance Tool | January 2018
How States Can Monitor Dual Eligible Special Needs Plan Performance: A Guide to Using CMS Data Resources
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)
January 2017
Medicaid Section 1115 Managed Long-Term Services and Supports Waivers: A Survey of Enrollment, Spending, and Program Policies
This report presents findings from a 2015 survey about § 1115 MLTSS waiver enrollment, spending, and program policies. (Kaiser Family Foundation)
Other Resource | March 2016
Minnesota Managed Care Longitudinal Data Analysis
This report compares utilization of community-based services by dually eligible beneficiaries enrolled in a fully integrated managed care program to those of beneficiaries receiving Medicare and Medicaid services from separate delivery systems.… (Office of the Assistant Secretary for Planning and Evaluation [ASPE])
Study Hall Call | May 2015
State Use of Medicare Advantage Encounter Data: Perspectives from Two States
Provides an overview of how state Medicaid agencies can obtain and use Medicare Advantage encounter data and shares insights from Arizona's and Tennessee's experiences with this process. (Integrated Care Resource Center)
Brief | May 2015
The Star Rating System and Medicare Advantage Plans
This brief examines how star rating are calculated and considerations around how differences among beneficiary populations should be recognized. (National Health Policy Forum)