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.
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)
The most recent demographic, enrollment, and expenditure data for dually eligible beneficiaries is in the zip file "State and County Data File 2012" found on the Medicare-Medicaid Coordination Office website. Additional data and statistical… (Centers for Medicare & Medicaid Services)
This brief explains Medicaid's role in providing supplemental coverage to Medicare beneficiaries. It also provides data on Medicaid spending for Medicare beneficiaries.
(Kaiser Family Foundation)
This report, mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 ("IMPACT Act"), details research conducted on the relationships between social rick factors and performance in Medicare's value-based… (Office of the Assistant Secretary for Planning and Evaluation [ASPE])
This report presents a conceptual social risk factor framework, and details the results of a literature review linking social risk factors to health care outcomes important to Medicare payment and quality programs.
(National Academies of Sciences, Engineering, and Medicine)
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 brief examines the potential of current and planned measures to accurately assess the performance of integrated care programs for dually eligible individuals.
(Center for Health Care Strategies)
This webinar explores Medicare Advantage plans' experience with the Star Ratings system, considers whether the system has served to drive quality improvement, how accurately it reflects plan management of quality and service, and what might… (National Health Policy Forum)
This brief examines how star rating are calculated and considerations around how differences among beneficiary populations should be recognized.
(National Health Policy Forum)
This webinar summarizes a discussion among states, the Centers for Medicare & Medicaid Services, the National Association of Medicaid Directors, and ICRC about Medicare Advantage Dual Eligible Special Needs Plan contract oversight and quality… (Integrated Care Resource Center)
The Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) provides all Medicare and Medicaid enrollment and claims data for dually eligible beneficiaries. This comprehensive suite of annual, calendar year data files contains Medicare… (ResDAC)
This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC about Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) contract oversight and quality monitoring procedures.
(Integrated Care Resource Center)
This brief reviews the quality measures chosen by eight states taking part in CMS' capitated model financial alignment demonstrations as of December 2013.
(The Commonwealth Fund)
This toolkit provides a practical guide to collecting, validating, and reporting Medicaid managed care encounter data and is designed as a guide for state Medicaid staff responsible for managing the daily operations involved in encounter data, as… (Mathematica)
This brief examines how states will need to build their information systems and internal capacity for data analysis as they pursue integrated care programs for Medicare-Medicaid enrollees.
(Center for Health Care Strategies)