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 fact sheet provides a comprehensive description of One Care, Massachusetts' demonstration project for adults with disabilities between the ages of 21 and 64 who are dually eligible for Medicare and Medicaid.
(Massachusetts Medicaid Policy Institute)
This policy brief describes the capitated financial alignment demonstration model, including information on financing, enrollment, provider network adequacy, medical necessity determinations, appeals, and quality and oversight.
(Kaiser Family Foundation)
This brief reviews primary care case management and related models to gather insights into key program design elements in managed fee-for-service models.
(Integrated Care Resource Center)
This brief examines issues in the development and implementation of managed care programs for Medicaid beneficiaries with disabilities, particularly policy considerations related to setting rates, developing provider networks and delivery systems,… (Kaiser Family Foundation)
This document articulates guiding principles that should be observed in designing and carrying out managed care initiatives involving people with chronic disabilities.
(National Council on Disability)
This document assesses the impact of managed care on people with disabilities to identify the opportunities/risks and strengths/weaknesses of pursuing managed care as a component of health care reform.
(National Council on Disability)
Meeting Agenda, Timeline, Map of Health Plan Options by County, Reimbursement Rates, Performance Measurement, Enrollment Data, Health Plan Presentations: PrimeWest, Cornerstone, UCare, South Country Health Alliance, Medica.
(Minnesota Department of Human Services)
This report offers recommendations for developing risk adjustment and rate-setting mechanisms to reinforce the goals of care integration.
(Massachusetts Medicaid Policy Institute)
This memo provides guidance to organizations interested in offering capitated financial alignment demonstration plans.
(Centers for Medicare & Medicaid Services)
This United Hospital Fund report focuses on measuring quality of care for Medicaid beneficiaries with complex needs, including those with multiple chronic conditions, behavioral health conditions, and long-term care needs, including dual eligibles.
(United Hospital Fund)
This report provides an overview of the LTQA Quality Measurement Workgroup's approach to identifying and disseminating quality measures for long-term services and supports that promote effective care transitions, improve health and quality of… (Long-Term Quality Alliance)
This presentation explores options for integrating physical and behavioral health services within coordinated delivery systems and how three states - Arizona, Tennessee, and Vermont - are approaching integration from different vantage points.
(Center for Health Care Strategies)
This brief discusses the reasons why it is important to engage stakeholder groups; how to identify distinct audience groups within stakeholder community; and how to target messages to specific groups.
(Center for Health Care Strategies)
This brief explores state options for integrating physical and behavioral health services within managed delivery systems, including examples of current state programs and critical considerations for implementation.
(Centers for Medicare & Medicaid Services)