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.
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 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)
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)
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 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)
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)
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 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)
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 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 brief shares strategies for hiring and training care managers for health plans with integrated care programs serving Medicare-Medicaid beneficiaries.
(Center for Health Care Strategies)