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 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 technical assistance tool covers key issues in RFPs and contracts related to behavioral health including coordination of behavioral health services, network availability of behavioral health services, and inclusion of behavioral health… (Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to consumer protection including marketing, member materials and education, continuity of care, and grievance and appeals processes.
(Integrated Care Resource Center)
This technical assistance tool covers key issues in RFPs and contracts related to care coordination including the structure of the care team, development of care plans, caseload requirements, and use of a centralized enrollee record.
(Integrated Care Resource Center)
This brief examines how providers, health plans, and community-based organizations in three counties experienced California’s transition of approximately 240,000 seniors and people with disabilities to Medicaid managed care.
(Kaiser Family Foundation)
This brief looks at the paths pursued by Florida, New Jersey, and Virginia in implementing MLTSS approaches focused on helping individuals to live in their communities rather than nursing facilities.
(Center for Health Care Strategies)
This brief examines how states will need to build their information systems and internal capacity for data analysis as they pursue integrated care programs for Medicare-Medicaid enrollees.
(Center for Health Care Strategies)
This report examines how two important consumer protections are addressed during implementation of MLTSS programs: (1) consumer choices; and (2) continuity of care.
(AARP Public Policy Institute)
This brief presents considerations for provider network development, reviews recent guidance, and offers examples of state practices for establishing MLTSS network adequacy standards.
(Center for Health Care Strategies)
This document provides a summary of the ten key elements that CMS expects to see incorporated into new and existing state Medicaid MLTSS programs.
(Centers for Medicare & Medicaid Services)
This document describes the ten key elements that CMS expects to see incorporated into new and existing state Medicaid MLTSS programs.
(Centers for Medicare & Medicaid Services)
This brief provides suggestions for designing and implementing integrated care initiatives that are of high quality, offer attractive benefits and services, and provide easy-to-understand education, outreach, and marketing information. It also… (Integrated Care Resource Center)