Helping states develop integrated programs for individuals who are dually eligible for Medicare and Medicaid
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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.
Dually eligible beneficiaries began enrolling in integrated Medicare-Medicaid plans (MMPs) under the Financial Alignment Initiative (FAI) in calendar year 2013. Under the FAI, the Centers for Medicare & Medicaid Services (CMS) and 10… (Mathematica)
During site visits to five states (Arizona, Florida, Illinois, New York, and Wisconsin), researchers identified major themes related to the rapid growth of Medicaid managed long-term services and supports (MLTSS) programs and the diversity of ways… (Mathematica)
This report provides preliminary data for the first 18 months of Washington's managed fee-for-service demonstration. It includes a description of the demonstration model, preliminary findings on eligibility and enrollment in the demonstration,… (RTI International)
This evaluation of the second year of the Initiative reports rates of all-cause hospitalizations and potentially avoidable hospitalizations, as well as Medicare expenditures for participating sites relative to a comparison group.
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.
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)
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.
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)