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 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)
Dual Eligible Special Needs Plans (D-SNPs) must develop a model of care (MOC) that describes their enrollees’ characteristics and health and service needs as well as the plan’s care coordination and health risk assessment processes. Despite the… (Integrated Care Resource Center)
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)
This MACPAC report reviews and analyzes care coordination requirements in the managed care organization contracts of nine states participating in demonstrations under the Financial Alignment Initiative, 10 states that contract with Fully Integrated… (Medicaid and CHIP Payment and Access Commission)
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 explores how health plans are: (1) addressing dually eligible members’ service needs that are beyond the scope of traditionally covered Medicare or Medicaid services; (2) assessing the value of offering these services; and (3)… (Center for Health Care Strategies)
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)
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)
This report summarizes care coordination models and care coordinator responsibilities in Medicaid managed long-term services and supports programs in 18 states.
(AARP Public Policy Institute)
The webinar features perspectives and lessons learned from two Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs) - HealthPartners in Minnesota and Bridgeway Health Solutions in Arizona - and from The Curators of the University of… (Integrated Care Resource Center)
Concerns about care transitions between acute and long-term services and supports (LTSS) settings have been raised since at least the 1990s. More recently, studies have emphasized the growing need to address care transitions from nursing homes to… (AARP Public Policy Institute)
The Community-Based Care Transitions Program (CCTP) supported by the CMS Center for Medicare & Medicaid Innovation tests models for improving care transitions from the hospital to other settings and reducing readmissions for high-risk Medicare… (Centers for Medicare & Medicaid Services)
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)
This brief outlines the options available to states in both capitated and fee-for-service arrangements to reduce avoidable hospitalizations from nursing facilities.
(Integrated Care Resource Center)
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)