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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 31

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)
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)
Technical Assistance Tool | July 2020
Using Medicare Modernization Act (MMA) Files to Identify Dually Eligible Individuals
States need to be able to identify individuals who are (or will become) dually eligible for several reasons. Since 2005, states have exchanged files -- known as the Medicare Modernization Act (MMA) files -- with the Centers for Medicare… (Integrated Care Resource Center)
Technical Assistance Tool | July 2020
State Guide to Identifying Aligned Enrollees: How to Find Medicare Plan Enrollment for Dually Eligible Individuals in Medicaid Managed Care Plans
States can advance integrated care for dually eligible individuals by promoting aligned enrollment in Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) and Medicaid managed care plans owned by the same parent company (“affiliated”… (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 | May 2019
Using Medicare Data to Support Integrated Care for Dually Eligible Beneficiaries
This webinar describes what Medicare and Medicaid data are publicly available and some simple tools that states can use to begin to explore these data. For states that are ready to undertake more in-depth analyses of Medicare data, the… (Integrated Care Resource Center)
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)
Technical Assistance Tool | November 2018
How States Can Better Understand their Dually Eligible Beneficiaries: A Guide to Using CMS Data Resources
This technical assistance tool shows states how to use data on Medicare-Medicaid dually eligible beneficiary demographics, service utilization, spending, and other characteristics to create tables, graphs, and figures and interpret their meaning for… (Integrated Care Resource Center)
Other Resource | August 2018
Benefits of Daily versus Monthly Buy-in Data Exchanges for Medicaid Agencies
This document describes the benefits of daily data exchanges with CMS. It also provides technical FAQs on buy-in data exchanges. (Centers for Medicare & Medicaid Services)
Tip Sheet | June 2018
Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Using Medicare Program Audit Reports to Improve Managed Care Organization Oversight
This tip sheet describes how states can use the results of Medicare program audits to identify performance issues impacting dually eligible beneficiaries’ receipt of care coordination, long-term services and supports, durable medical equipment… (Integrated Care Resource Center)
Technical Assistance Tool | January 2018
How States Can Monitor Dual Eligible Special Needs Plan Performance: A Guide to Using CMS Data Resources
This resource shows how states can use data from the Centers of Medicare and Medicaid to create tables, graphs, and figures and interpret their meaning in order to assess D-SNP performance. (Integrated Care Resource Center)
Other Resource | November 2017
Data Analysis Brief: Medicare-Medicaid Dual Enrollment from 2006 through 2016
This analysis examines trends in enrollment and eligibility for Medicare-Medicaid enrollees. (Centers for Medicare & Medicaid Services)
September 2017
State and National Profiles of Medicare-Medicaid Enrollees
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)