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 examines key policy and operational considerations related to the transition from fee-for-service to risk-based capitated managed care for LTSS.
(Kaiser Family Foundation)
This webinar explains participant direction and how it can be included in contract language; also describes how Arizona implemented consumer direction in its long-term care system.
(Integrated Care Resource Center)
This technical assistance tool provides states with options to evaluate health plans' past performance as they consider those plans for participation in their integrated Medicare-Medicaid programs.
(Integrated Care Resource Center)
This brief provides basic information on Medicare Part D, including how beneficiaries are enrolled in Part D, how Part D drugs are paid for, what drugs are and are not covered in Part D, how drug utilization is managed in Part D, and how the Part D… (Integrated Care Resource Center)
This reports outlines a strategy or "roadmap" for evaluating the quality and person-centeredness of integrated care.
(National Committee for Quality Assurance)
Chapter 5 of this report to Congress examines rate setting in capitated integrated care programs including PACE.
(Medicaid and CHIP Payment and Access Commission)
The National Resource Center for Participant-Directed Services explains participant direction and how it can be included in contract language, and staff from the Arizona Health Care Cost Containment System give an example of how Arizona implemented… (Integrated Care Resource Center)
This presentation highlights new data, promising care delivery models, and policies intended to support integrated medical care, behavioral health care, and long-term services and supports for Medicare beneficiaries with serious mental illness.
(The SCAN Foundation)
This report examines how five states have structured the interface between MFP demonstration grants and Managed long-term services and supports (MLTSS) programs to promote transitions from institutional care to home- and community-based settings.
(Mathematica)
This case study highlights a chronic conditions special needs plan (C-SNP) for Medicare and dual eligible beneficiaries with serious mental illness that integrates physical and behavioral health services for enrollees.
(Center for Health Care Strategies)
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)
This report provides an overview of LTSS, the risks and benefits of Medicaid MLTSS, policy recommendations and promising practices from states that have implemented these programs.
(Community Catalyst)
This policy brief summarizes the terms of Massachusetts' MOU in the several key areas, including enrollment, care delivery model, benefits, financing, beneficiary protections and monitoring and evaluation.
(Kaiser Family Foundation)