Brief

Low-Cost, Low-Administrative Burden Ways to Better Integrate Care for Medicare-Medicaid Enrollees

This brief discusses concrete, actionable steps that states can take to move toward more integrated care for Medicare-Medicaid enrollees.

Key Themes in Capitated Medicaid Managed Long-Term Services and Supports Waivers

This issue brief examines key themes in 19 capitated Medicaid MLTSS waivers approved to date by the Centers for Medicare and Medicaid Services (CMS), including section 1115 (a) demonstrations in 12 states and 1915 (b)/(c) waivers in six states.

Key Attributes of High-Performing Integrated Health Plans for Medicare-Medicaid Enrollees

This brief introduces a framework outlining the key attributes of high-performing health plans that are necessary to support integrated care for Medicare-Medicaid enrollees.

Interdisciplinary Care Teams for Medicare-Medicaid Enrollees: Considerations for States

This brief describes key considerations for developing interdisciplinary care teams and explores how eight states addressed issues such as engaging providers and measurement approaches.

Integrated Appeals Processes for Medicare-Medicaid Enrollees: Lessons from States

This brief explores opportunities for states to develop an integrated appeals process, whether through a D-SNP or a financial alignment demonstration.

From the Beneficiary Perspective: Core Elements to Guide Integrated Care for Dual Eligibles

This brief describes nine core program elements that are critical for achieving high-quality, patient-centered, and cost-effective care for dually eligible beneficiaries.

Financial Alignment Initiative for Beneficiaries Dually Eligible for Medicaid and Medicare

This brief describes the design of the Financial Alignment Initiative and compares key provisions of the 10 capitated model demonstrations. Separate fact sheets are available on each of the 10 demonstrations.

Engaging Providers in Building Managed Care Delivery Systems: Tips for States

This brief provides tips to help states engage providers in designing, implementing, and overseeing a managed care delivery system for individuals with complex care needs.

Effective Transitions between Care Settings

Concerns about care transitions between acute and long-term services and supports (LTSS) settings have been raised since at least the 1990s. More recently, studies have emphasized the growing need to address care transitions from nursing homes to community-based settings, as well as to divert people from nursing homes. This brief looks at six ways states can measure and improve effective transitions between acute care, long-term care, and the community.

Developing Provider Networks for Medicaid Managed Long-Term Services and Supports Programs: Considerations for States

This brief presents considerations for provider network development, reviews recent guidance, and offers examples of state practices for establishing MLTSS network adequacy standards.