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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 17

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 | 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 | 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)
August 2016
Managed Long-Term Services and Supports Rate Setting Resource Center
This resource center gives states tools for developing or refining rate-setting methods for Medicaid managed long-term services and supports (MLTSS) or Medicare-Medicaid integrated care programs. (Center for Health Care Strategies)
Study Hall Call | March 2016
Overview of State Considerations for Medicaid Managed Long-Term Services and Supports (MLTSS) Rate Setting
This webinar features an overview of MLTSS rate setting basics, shares initial findings from a project on Medicaid MLTSS rate setting, and also includes a facilitated discussion with an expert actuary and state representatives from Tennessee and… (Integrated Care Resource Center)
Brief | January 2016
Developing Capitation Rates for Medicaid Managed Long-Term Services and Supports Programs: State Considerations
This brief examines considerations for rate setting in Medicaid managed long-term services and supports (MLTSS) programs and spotlights the experiences of eight statesin establishing MLTSS payment rates. (Center for Health Care Strategies)
Study Hall Call | January 2015
Building and Validating LTSS Provider Networks
This presentation examines strategies for states establishing Medicaid MLTSS or integrated care programs to ensure that health plans develop LTSS provider networks to address beneficiaries' diverse needs. (Integrated Care Resource Center)
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)
Other Resource | July 2014
Identifying Community-Based Resources: Key Considerations for Health Plans
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)
Brief | April 2014
Improving Coordination of Home Health Services and Durable Medical Equipment for Medicare-Medicaid Enrollees in the Financial Alignment Initiative
This brief outlines challenges caused by the overlap in Medicare and Medicaid coverage for home health services and durable medical equipment and describes options for addressing these issues in the Financial Alignment Initiative and other… (Integrated Care Resource Center)
Other Resource | January 2014
Medicare Advantage Network Adequacy Requirements, D-SNPs, and State Contracting Options
This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage network adequacy requirements and their application to D-SNPs. (Integrated Care Resource Center)
Other Resource | December 2013
Ready, Set, Go! The Readiness Review Process for Care Coordination and Provider Network Adequacy in Five States
This report spotlights the approaches used by five states - Arizona, Minnesota, Tennessee, Texas, and Wisconsin - to ensure managed care organizations are ready to provide care coordination services to consumers and adequate access to needed long-… (AARP Public Policy Institute)
Brief | July 2013
Developing Provider Networks for Medicaid Managed Long-Term Services and Supports Programs: Considerations for States
This brief presents considerations for provider network development, reviews recent guidance, and offers examples of state practices for establishing MLTSS network adequacy standards. (Center for Health Care Strategies)
May 2013
Transitioning Long Term Services and Supports Providers Into Managed Care Programs
This paper identifies concerns and considerations in incorporating traditional LTSS providers into a managed care program. (Truven Health Analytics)