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 describes a Microsoft Access tool to prioritize information in the MARx system Daily Transaction Reply Report, and it explains states can use it to improve the timeliness and efficiency of their demonstration enrollment processes.
(Integrated Care Resource Center)
This report compares utilization of community-based services by dually eligible beneficiaries enrolled in a fully integrated managed care program to those of beneficiaries receiving Medicare and Medicaid services from separate delivery systems.… (Office of the Assistant Secretary for Planning and Evaluation [ASPE])
During site visits to five states (Arizona, Florida, Illinois, New York, and Wisconsin), researchers identified major themes related to the rapid growth of Medicaid managed long-term services and supports (MLTSS) programs and the diversity of ways… (Mathematica)
This report provides preliminary data for the first 18 months of Washington's managed fee-for-service demonstration. It includes a description of the demonstration model, preliminary findings on eligibility and enrollment in the demonstration,… (RTI International)
This brief examines considerations for rate setting in Medicaid managed long-term services and supports (MLTSS) programs and spotlights the experiences of eight statesin establishing MLTSS payment rates.
(Center for Health Care Strategies)
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 tool describes the key areas of information that demonstration enrollment brokers' customer service representatives should master to improve the quality of decision-support services for beneficiaries who are being passively enrolled in a… (Integrated Care Resource Center)
This report describes early implementation activities occurring in the first six months of the seven financial alignment demonstrations launched as of May 1, 2014.
(RTI International)
This brief describes the design of the Financial Alignment Initiative and compares key provisions of the 10 capitated model demonstrations. Separate fact sheets are available on each of the 10 demonstrations.
(Medicaid and CHIP Payment and Access Commission)
This report summarizes care coordination models and care coordinator responsibilities in Medicaid managed long-term services and supports programs in 18 states.
(AARP Public Policy Institute)
This report describes beneficiary experiences with enrollment processes, communication about the model of care, and understanding of care coordination services under the capitated model financial alignment demonstrations.
(Medicaid and CHIP Payment and Access Commission)
This tool will be used by CMS to perform compliance reviews on state Home and Community Based Services (HCBS) Transition Plans.
(Centers for Medicare & Medicaid Services)
This document summarizes key discussions during a roundtable with a group of federal and state officials and other experts on issues related to how rebalancing progress in capitated Medicaid MLTSS programs is measured.
(Kaiser Family Foundation)
This brief explores opportunities for states to develop an integrated appeals process, whether through a D-SNP or a financial alignment demonstration.
(Center for Health Care Strategies)