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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.

Displaying 466 - 480 of 572

Other Resource | January 2014
Cooperative Agreement between Pennsylvania Dept. of Public Welfare and Medicare Advantage Health Plan
(Pennsylvania Dept. of Public Welfare)
Study Hall Call | January 2014
Medicare Advantage Network Adequacy Requirements, D-SNPs, and State Contracting Options
This document summarizes a discussion among states, Centers for Medicare & Medicaid Services, the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage network adequacy requirements and their application to Dual… (Integrated Care Resource Center)
Other Resource | January 2014
Medicare Advantage Network Adequacy Requirements, D-SNPs, and State Contracting Options
This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage network adequacy requirements and their application to D-SNPs. (Integrated Care Resource Center)
January 2014
Evaluating PACE: A Review of the Literature
This report uses existing evaluations of PACE to summarize the available evidence on the effect of PACE on: Medicare and Medicaid costs; hospital and nursing facility use; quality of care, satisfaction and quality of life; and mortality. (Assistant Secretary for Planning and Evaluation)
Study Hall Call | December 2013
Hospital to Community Transitions for Medicare-Medicaid Enrollees
This presentation describes the approach of health plans in Arizona and Minnesota to managing care transitions by Medicare-Medicaid enrollees and other beneficiaries with complex conditions. (Integrated Care Resource Center)
Other Resource | December 2013
Ready, Set, Go! The Readiness Review Process for Care Coordination and Provider Network Adequacy in Five States
This report spotlights the approaches used by five states - Arizona, Minnesota, Tennessee, Texas, and Wisconsin - to ensure managed care organizations are ready to provide care coordination services to consumers and adequate access to needed long-… (AARP Public Policy Institute)
November 2013
Encounter Data Toolkit
This toolkit provides a practical guide to collecting, validating, and reporting Medicaid managed care encounter data and is designed as a guide for state Medicaid staff responsible for managing the daily operations involved in encounter data, as… (Mathematica)
Webinars and Trainings | October 2013
Three-Way Contracting - The Massachusetts Experience
Study Hall Call | October 2013
Three-Way Contracting - The Massachusetts Experience
In this presentation, CMS and MassHealth staff provide different perspectives on the challenges and successes of the three-way contracting process in Massachusetts, including discussion of managing timeframes and interacting with health plans. (Integrated Care Resource Center)
Technical Assistance Tool | October 2013
Application of Existing External Quality Review Protocols to Managed Long Term Services and Supports
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)
Technical Assistance Tool | July 2013
Selected Provisions from Integrated Care RFPs and Contracts: Behavioral Health
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)
Technical Assistance Tool | July 2013
Selected Provisions from Integrated Care RFPs and Contracts: Consumer Protection
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)
Technical Assistance Tool | July 2013
Selected Provisions from Integrated Care RFPs and Contracts: Care Coordination
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)
Brief | July 2013
Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care: Insights from California
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)
Brief | July 2013
Three State Paths to Improve Medicaid Managed Long-Term Care: Florida, New Jersey, and Virginia
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)