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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 42

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)
Technical Assistance Tool | July 2023
Glossary of Terms Related to Integrated Care for Dually Eligible Individuals
This resource was updated in July 2023 to include updated definitions of Dual Eligible Special Needs Plans (D-SNPs), Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs), Highly Integrated Dual Eligible Special Needs Plans (HIDE SNPs), and… (Integrated Care Resource Center)
Tip Sheet | June 2023
Definitions of Different Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) Types in 2023 and 2025
This resource was updated in June 2023 to correct an error in the definition of applicable integrated plan in the previous version. Dual Eligible Special Needs Plans (D-SNPs) must hold contracts with state Medicaid agencies, and states can use… (Integrated Care Resource Center)
Tip Sheet | May 2023
Tips to Help States Select Medicaid Managed Care Authorities as They Design Integrated Care Initiatives for Dually Eligible Individuals
This tip sheet summarizes key considerations for states trying to decide which pathway to use to advance Medicare-Medicaid integration, and which Medicaid managed care authority(ies) might best support that pathway. Although the tip sheet presents… (Integrated Care Resource Center)
February 2023
Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid
This report provides data on the characteristics of dually eligible individuals and information on their use of services and costs of care. (Medicare Payment Advisory Commission)
Tip Sheet, Other Resource | April 2022
Dually Eligible Individuals: The Basics
ICRC has developed a basic fact sheet on individuals who are dually eligible for Medicare and Medicaid. (Integrated Care Resource Center)
Technical Assistance Tool | December 2021
Fillable Tables for States Assessing the Fiscal Viability of a Medicare Part A Buy-in Agreement
States may execute a Medicare Part A buy-in agreement with the Centers for Medicare & Medicaid Services (CMS) to facilitate access to Medicare Part A and dual eligible status under the Qualified Medicare Beneficiary (QMB) eligibility group. This… (Integrated Care Resource Center)
Technical Assistance Tool | December 2021
Assessing the Fiscal Viability of a Medicare Part A Buy-in Agreement in Group Payer States
States may execute a Medicare Part A buy-in agreement with the Centers for Medicare & Medicaid Services (CMS) to facilitate access to Medicare Part A and dual eligible status under the Qualified Medicare Beneficiary (QMB) eligibility group. This… (Integrated Care Resource Center)
Other Resource | May 2020
Data Analysis Brief: Managed Care Enrollment Trends among Dually Eligible and Medicare-only Beneficiaries, 2006 through 2018
This analysis examines trends in enrollment and eligibility for Medicare-Medicaid enrollees. (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)
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)
Other Resource | March 2019
Three New Opportunities to Test Innovative Models of Integrated Care for Individuals Dually Eligible for Medicaid and Medicare
This State Medicaid Director Letter invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial… (Centers for Medicare & Medicaid Services)
Other Resource | March 2019
People Dually Eligible for Medicare and Medicaid
In 2017, there were 12 million individuals dually eligible for Medicare and Medicaid. This fact sheet provides information on their reasons for Medicare eligibility, costs of care, and enrollment in managed care as well as the… (Centers for Medicare & Medicaid Services)
Other Resource | March 2019
Part A Buy-in Agreements for States - Q&A
This document provides answers to states' frequently asked questions about Medicare Part A Buy-in. It describes the advantages to states of having a Buy-in agreement and how these agreements can help to promote access to integrated care for dually… (Centers for Medicare & Medicaid Services)