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 webinar describes the retroactive submission process, including how to use CMS' Electronic Retroactive Processing Transmission (eRPT) application to transmit enrollment transactions to the Retroactive Processing Contractor.
(Integrated Care Resource Center)
This document answers questions that states have asked about improving the processes they use to regularly identify prospective Medicare-Medicaid individuals for potential enrollment into their capitated financial alignment demonstrations.
(Integrated Care Resource Center)
This technical assistance tool lists questions frequently asked by beneficiaries enrolling in capitated Financial Alignment Initiative demonstrations, and provides potential responses by enrollment brokers' customer service representatives (… (Integrated Care Resource Center)
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 webinar describes an opportunity identify prospective Medicare-Medicaid enrollees for enrollment into capitated financial alignment demonstrations and provides perspectives from Massachusetts and Michigan on states' use of this process.… (Integrated Care Resource Center)
This webinar features state experiences using data-driven strategies to analyze opt-outs and engage beneficiaries and providers in financial alignment demonstrations.
(Integrated Care Resource Center)
This document describes the process that states and health plans participating in the capitated financial alignment demonstrations use to submit information to CMS' MARx systems.
(Centers for Medicare & Medicaid Services)
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 presentation introduces state enrollment staff to a tool to help prioritize transaction reply codes and simplify enrollment reconciliation.
(Integrated Care Resource Center)
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 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 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 brief examines how star rating are calculated and considerations around how differences among beneficiary populations should be recognized.
(National Health Policy Forum)
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)