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 document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage network adequacy requirements and their application to D-SNPs.
(Integrated Care Resource Center)
This report spotlights the approaches used by five states - Arizona, Minnesota, Tennessee, Texas, and Wisconsin - to ensure managed care organizations are ready to provide care coordination services to consumers and adequate access to needed long-… (AARP Public Policy Institute)
In this presentation, CMS and MassHealth staff provide different perspectives on the challenges and successes of the three-way contracting process in Massachusetts, including discussion of managing timeframes and interacting with health plans.
(Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to consumer protection including marketing, member materials and education, continuity of care, and grievance and appeals processes.
(Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to care coordination including the structure of the care team, development of care plans, caseload requirements, and use of a centralized enrollee record.
(Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to behavioral health including coordination of behavioral health services, network availability of behavioral health services, and inclusion of behavioral health… (Integrated Care Resource Center)
This brief provides suggestions for designing and implementing integrated care initiatives that are of high quality, offer attractive benefits and services, and provide easy-to-understand education, outreach, and marketing information. It also… (Integrated Care Resource Center)
This technical assistance tool provides states with options to evaluate health plans' past performance as they consider those plans for participation in their integrated Medicare-Medicaid programs.
(Integrated Care Resource Center)
This brief provides basic information on Medicare Part D, including how beneficiaries are enrolled in Part D, how Part D drugs are paid for, what drugs are and are not covered in Part D, how drug utilization is managed in Part D, and how the Part D… (Integrated Care Resource Center)
This background paper examines the contents of states' proposals in the areas of target population, implementation date, enrollment, financing, benefits, beneficiary protections, stakeholder engagement, and demonstration evaluation.
(Kaiser Family Foundation)
This paper gives an overview of the proposals submitted by states to test two models to align Medicare and Medicaid benefits and financing for dually eligible beneficiaries with the goal of delivering better coordinated care and reducing costs.
(Kaiser Family Foundation)
This presentation describes the readiness review process that Tennessee used with health plans participating in its Medicaid MLTSS program.
(Integrated Care Resource Center)
This study examines how eight state Medicaid agencies, experienced in overseeing these programs, monitor the performance of plan contractors to ensure they provide optimal care to enrollees.
(AARP Public Policy Institute)