Helping states develop integrated programs for individuals who are dually eligible for Medicare and Medicaid
Aligned Medicare and Medicaid provider networks can improve the care experience of D-SNP enrollees by eliminating the need to navigate separate Medicare and Medicaid provider networks to access care. During this ICRC state-only call, ICRC staff briefly described federal provider network adequacy requirements for D-SNPs.
In this informational discussion, speakers from the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) provided an overview of the Long-term Enhanced ACO Design (LEAD) Model and opportunities for state participation. LEAD includes a novel Medicare-Medicaid integration component that has not been tested in previous CMS ACO models and programs. Under this component, ACOs will be able to partner with plans and states to offer a more comprehensive, integrated approach to serving full-benefit dually eligible individuals with Original Medicare.
This webinar describes the opportunity for states to require Dual Eligible Special Needs Plans (D-SNPs) that operate with exclusively aligned enrollment to establish contracts with the Centers for Medicare & Medicaid Services (CMS) that only include one or more D-SNPs within a state and integrate certain materials for enrollees.
Learning Objectives: By the end of this presentation, attendees should be able to:
This webinar describes the Medicare resources available to states to monitor D-SNP performance and provide tips for states on incorporating D-SNPs into Medicaid quality improvement activities.
Learning Objectives: By the end of this presentation, attendees should be able to:
This webinar discusses strategies states can use to encourage enrollment in integrated care programs, including communicating the value of integrated care to dually eligible individuals through direct outreach and education, partnering with SHIPs and other trusted organizations to educate dually eligible individuals, and leveraging policy options to promote enrollment in integrated care programs. This webinar also describes discuss additional factors that can affect integrated care program enrollment.
In this webinar, ICRC team members explain how exclusively aligned enrollment (EAE) promotes integration of Medicare and Medicaid benefits for dually eligible individuals enrolled in Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs), describe three models that states can use to achieve exclusively aligned enrollment in D-SNPs, and outline key considerations and steps for states in designing and implementing exclusively aligned enrollment.
Learning Objectives: By the end of this presentation, attendees should be able to:
This webinar will discuss strategies states can use to improve care coordination for D-SNP enrollees. It provides an overview of federal D-SNP care coordination and Model of Care (MOC) requirements, describes state options for incorporating care coordination requirements into state Medicaid agency contracts (SMACs) with D-SNPs, and/or requiring D-SNPs to incorporate state-specific information into MOCs, and discusses key considerations for states when implementing state-specific care coordination requirements.
This webinar explains the potential benefits for states of selectively contracting with D-SNPs, key building blocks for selective contracting, considerations for states when deciding to selectively contract with D-SNPs, and steps that states can take when implementing selective contracting.
Learning Objectives: By the end of this presentation, attendees should be able to:
The webinar provides an overview of Medicare and Medicaid nursing facility benefits and payment methods, as well as options to improve coordination and quality of nursing facility benefits for dually eligible individuals in both fee-for-service and managed care systems.
Learning Objectives: By the end of this presentation, attendees are able to describe: