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.
To better inform analysis of existing policies and development of future policies that affect Medicaid payments, the Medicaid and CHIP Payment and Access Commission (MACPAC) released a compendium of each state’s fee-forservice DME policies along… (Medicaid and CHIP Payment and Access Commission)
This Centers for Medicare & Medicaid Services (CMS) Informational Bulletin provides an additional strategy for states to support timely access to durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) for people dually eligible… (Centers for Medicare & Medicaid Services)
This brief describes several administrative changes that state Medicaid programs can make to: (1) support integration efforts; (2) improve beneficiaries’ experience of care; (3) decrease beneficiary out-of-pocket costs; and (4) reduce provider… (Integrated Care Resource Center)
This brief describes how three states – California, Connecticut, and Illinois -- promote dually eligible beneficiaries’ access to durable medical equipment (DME) in a fee-for-service environment through the use of provisional prior authorization… (Integrated Care Resource Center)
This webinar provides an overview of the Administration for Community Living's initiative to improve the business acumen of community-based organizations (CBOs) and features perspectives from a CBO and a health plan on building contractual… (Integrated Care Resource Center)
This issue brief details four considerations that community-based organizations (CBOs) need to address when assessing the feasibility of participating in a managed long-term services and supports program: (1) relevant skill set and experience; (2)… (National Association of States United for Aging and Disabilities)
This presentation highlights issues with overlapping coverage for home health services and durable medical equipment (DME), and describes the Health Plan of San Mateo's approach to coordinating these services, including operating protocols,… (Integrated Care Resource Center)
This fact sheet for health plans lists community-based resources and how they may help to address the needs of Medicare-Medicaid enrollees.
(Resources for Integrated Care)
This brief outlines challenges caused by the overlap in Medicare and Medicaid coverage for home health services and durable medical equipment and describes options for addressing these issues in the Financial Alignment Initiative and other… (Integrated Care Resource Center)
This report details development of quality indicators for individuals receiving home- and community-based services.
(Agency for Healthcare Research and Quality)
This brief discusses strategies for structuring rates for managed long-term services and supports programs to encourage the use of home- and community-based services and details states experiences in setting rates for these programs.
(Center for Health Care Strategies)