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 State Medicaid Director Letter highlights ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid. These opportunities, which do not require demonstration authority or Medicare waivers, fall into… (Centers for Medicare & Medicaid Services)
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)
These profiles provide demographic, enrollment, and expenditure data for Medicare-Medicaid Enrollees. See the data reports for additional details: National Summary 2012 | National Data File 2012 | State and County Data File 2012 | National and… (Centers for Medicare & Medicaid Services)
This tip sheet suggests steps that managed care plans can take to ensure that case managers are effectively trained on approaches to promote person-centered planning in self-directed delivery models for home- and community-based services.
(Integrated Care Resource Center)
This questionnaire helps individuals and health plan case managers to select an appropriate person to be informally designated as a representative decision-maker.
(Integrated Care Resource Center)
This tip sheet offers suggestions for states operating managed long-term services and supports programs or other managed integrated care programs to: (1) understand the person-centered planning process; (2) establish robust contract requirements and… (Integrated Care Resource Center)
This tool gives examples of the roles and responsibilities of the individual, representative, case manager, information and assistance function, the financial management services function, and the direct care worker.
(Integrated Care Resource Center)
This questionnaire helps case managers to assess the ability of an individual to self-direct services, and if the individual requires assistance from a representative.
(Integrated Care Resource Center)
This resource suggests topics to be covered in a policies and procedures manual for the day-to-day management of the self-direction program. Programs should add topics as needed to ensure efficient and consistent program operations.
(Integrated Care Resource Center)
This document offers the Centers for Medicare & Medicaid Services' (CMS) guidelines for permissible goods and services, and can be customized to include additional state guidelines.
(Integrated Care Resource Center)
This document reviews the individual's rights under the self-directed option as well as his or her associated responsibilities for participation.
(Integrated Care Resource Center)
This document answers common questions about self-direction including: (1) what is self-direction and why is it an important option for individuals receiving HCBS; (2) what are the components of self-direction. The document also defines self-… (Integrated Care Resource Center)
This third edition of the scorecard measures state performance in creating a high-quality system of care for older adults and people with physical disabilities, and their family caregivers. The report presents results across five dimensions: (1)… (AARP Public Policy Institute)