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 25

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 | 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 | 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)
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)
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])
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)
Study Hall Call | September 2014
Improving Coordination of Home Health Services and Durable Medical Equipment for Medicare-Medicaid Enrollees in the Financial Alignment Initiative
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)
June 2014
Raising Expectations, 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers
This second edition of the scorecard measures state-level performance on five dimensions: (1) affordability and access; (2) choice; (3) quality; (4) support for family caregivers; and (5) effective transitions. (AARP Public Policy Institute)