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 a national overview of long-term services and supports (LTSS) rebalancing and highlights 10 states – Missouri, Massachusetts, New York, New Jersey, Connecticut, Colorado, South Carolina, Illinois, Nevada, and Arkansas… (Centers for Medicare & Medicaid Services)
This webinar describes four new quality measures specifically designed for use by Medicaid managed long-term services and supports (MLTSS) plans, which address comprehensive assessments, comprehensive care plans, shared care plans with primary… (Integrated Care Resource Center)
This webinar provides an overview of two health plans' approaches to Medicare-Medicaid value based purchasing (VBP) with nursing facilities. The presentation also features a panel discussion on Medicare-Medicaid nursing facility VBP with discussants… (Integrated Care Resource Center)
This brief describes value-based payment approaches currently used in select states and managed care plans, including the quality and performance measures they use, benchmarks or targets for those measures, and incentives that reward facilities. It… (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 resource center gives states tools for developing or refining rate-setting methods for Medicaid managed long-term services and supports (MLTSS) or Medicare-Medicaid integrated care programs.
(Center for Health Care Strategies)
This webinar features an overview of MLTSS rate setting basics, shares initial findings from a project on Medicaid MLTSS rate setting, and also includes a facilitated discussion with an expert actuary and state representatives from Tennessee and… (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])
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 second edition of the scorecard measures state-level performance on five dimensions: (1) affordability and access; (2) choice; (3) quality; (4) support for family caregivers; and (5) effective transitions.
(AARP Public Policy Institute)
This tool is a road map for states to use in interpreting and applying existing External Quality Review protocols when assessing Medicaid MLTSS program compliance.
(Centers for Medicare & Medicaid Services)
This presentation describes the objectives of the rate setting process, basic approach, rate structure, and risk mitigation strategies and provides state examples.
(Integrated Care Resource Center)
This paper provides resources to help state advocates identify measures that can help determine if the identified needs and goals of people with disabilities and seniors are being met.
(Disability Rights Education & Defense Fund)