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 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)
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)
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)
This fact sheet, updated in July 2019, summarizes default enrollment requirements and state roles in the default enrollment approval and implementation process. It also provides references to additional resources for more detail and… (Integrated Care Resource Center)
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)
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)
This resource is a model letter that D-SNPs have the option to use to meet CMS beneficiary notice requirements for default enrollment. All letters used will need to contain the required CMS disclaimers, materials ID and receive appropriate CMS… (Medicare-Medicaid Coordination Office)
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)
This webinar provides a history of seamless conversion and describes the new process for default enrollment that will start in 2019. This webinar also explains states’ roles in this process, including the need to identify beneficiaries newly… (Integrated Care Resource Center)
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)
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)