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.
The Centers for Medicare & Medicaid Services (CMS) uses a five-star quality rating system to evaluate the performance of Medicare Advantage (MA) health plans. This Star Rating system enables beneficiaries, payers, and others to compare plans… (Integrated Care Resource Center)
This memo provides information to Medicare Advantage organizations regarding the opportunity to transition enrollees in Dual Eligible Special Needs Plan (D-SNP) “look-alikes” for CY 2021.
(Centers for Medicare & Medicaid Services)
To help states explore their options for Medicare-Medicaid integration, ICRC created this tool, which shares steps states can take to advance integration, beginning with relatively simple administrative actions and moving to more advanced activities… (Integrated Care Resource Center)
This webinar covers resources and strategies available to states to begin or improve their oversight of Dual Eligible Special Needs Plans (D-SNPs). Presenters provide an overview of the Centers for Medicare & Medicaid Services’ (CMS) publicly… (Integrated Care Resource Center)
This State Medicaid Director Letter invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial Alignment… (Centers for Medicare & Medicaid Services)
To provide more integrated, coordinated care for its residents who are dually eligible for Medicare and Medicaid, Washington State is operating a demonstration under the Financial Alignment Initiative offered by the Centers for Medicare &… (Integrated Care Resource Center)
This State Medicaid Director Letter highlights ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid. These opportunities, which do not require demonstration authority or Medicare waivers, fall into three… (Centers for Medicare & Medicaid Services)
This tip sheet describes how states can use the results of Medicare program audits to identify performance issues impacting dually eligible beneficiaries’ receipt of care coordination, long-term services and supports, durable medical equipment, and… (Integrated Care Resource Center)
This resource shows how states can use data from the Centers of Medicare and Medicaid to create tables, graphs, and figures and interpret their meaning in order to assess D-SNP performance.
(Integrated Care Resource Center)
This brief highlights insights from states that are fine-tuning their integrated care programsandcan help other states design their own integrated care programs to meet beneficiaryneeds.
(Center for Health Care Strategies)
This brief provides an overview of four integration models: (1) Dual Eligible Special Needs Plan-based; (2) Financial Alignment Initiative-based; (3) the Program of All-Inclusive Care for the Elderly; and (4) accountable care organizations and… (Center for Health Care Strategies)
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)