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 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)
This CMS Informational Bulletin describes existing flexibilities that can: (1) assist states in meeting their obligations to screen Medicaid enrollees for Medicare Savings Programs and other categories of Medicaid when the enrollees become Medicare-… (Centers for Medicare & Medicaid Services)
This brief assesses Washington State's oversight of Medicaid managed care plan performance under the state's 1915 (b) waiver by quantifying monitoring practices and comparing them to benchmarks inside and outside of Washington State.
(Mathematica)
This brief provides tips on finding hard-to-locate members from seven health plans participating in a national initiative focused on advancing health plan strategies to provide high-quality, cost-effective care for high-need populations eligible for… (Center for Health Care Strategies)
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 tips for engaging providers throughout the design and implementation of integrated care programs; describes Virginia's approach to provider engagement for its financial alignment demonstration; and includes an… (Integrated Care Resource Center)
This brief describes how three states - California, Ohio, and Virginia - are requiring Medicare-Medicaid Plans to stratify Medicare-Medicaid enrollees by their level of need within capitated financial alignment demonstrations.
(Center for Health Care Strategies)
This issue brief examines key themes in 19 capitated Medicaid MLTSS waivers approved to date by the Centers for Medicare and Medicaid Services (CMS), including section 1115 (a) demonstrations in 12 states and 1915 (b)/(c) waivers in six states.
(Kaiser Family Foundation)
This presentation provides an overview of the major differences between Medicare and Medicaid marketing requirements and opportunities for better alignment, and it also offers lessons from MassHealth's roll out of Massachusetts' integrated… (Integrated Care Resource Center)
This webpage describes an initiative to redesign California's Medi-Cal stakeholder engagement process, including an online survey of stakeholders.
(California Department of Health Care Services)
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)
In this presentation, an ICRC speaker describes the basic principles of MLTSS program oversight and state performance monitoring practices for Medicaid MLTSS programs. In addition, a speaker from Texas offers operational insight on oversight of the… (Integrated Care Resource Center)
This resource provides updated enrollment information, describes the state's response to administrative issues it has encountered, lists outreach efforts, budget issues, and other news.
(The SCAN Foundation)
This report examines strategies states are using to address or eliminate system-level barriers to integrated care for Medicaid beneficiaries with both physical and behavioral health care needs.
(The Commonwealth Fund)
This brief introduces a framework outlining the key attributes of high-performing health plans that are necessary to support integrated care for Medicare-Medicaid enrollees.
(Center for Health Care Strategies)