Integration models based on Dual Eligible Special Needs Plans (D-SNPs) are shaped by state contracting strategies. All D-SNPs must have a contract with the Medicaid agency in the states where they operate; however, states do not have to contract with D-SNPs. States can use this flexibility to shape their integrated care programs, and they can add requirements to their contracts with D-SNPs to create more advanced integration programs.

Learn More

  • State Contracting with D-SNPs: Introduction to D-SNPs and D-SNP Contracting Basics

    This is part one of a two-part series that provides an overview of state strategies for contracting with D-SNPs to improve care coordination and Medicare-Medicaid alignment for dually eligible enrollees. The webinars are especially helpful to state staff who are new to or seek a refresher on D-SNP contracting and working with Medicare plans. (ICRC, December 2022)

  • State Contracting with D-SNPs: Using D-SNPs to Integrate Care for Dually Eligible Individuals

    This is part two of a two-part series that provides an overview of state strategies for contracting with D-SNPs to improve care coordination and Medicare-Medicaid alignment for dually eligible enrollees. The webinars are especially helpful to state staff who are new to or seek a refresher on D-SNP contracting and working with Medicare plans. (ICRC, December 2022)

  • Definitions of Different D-SNP Types in 2023 and 2025

    This tip sheet summarizes the updated definitions of FIDE SNPs, HIDE SNPs, CO D-SNPs, and AIPs for 2023 and compares the requirements for each D-SNP type. This information can be helpful to states as they develop and implement programs that advance Medicare-Medicaid integration for their dually eligible populations. (ICRC, December 2022)

  • Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans

    To operate in a state, a Dual Eligible Special Needs Plan(D-SNP) must hold a contract with the state Medicaid agency.  Those state Medicaid agency contracts (SMACs) must all have at least certain minimum elements, and states can also add additional requirements that aim to further coordination or integration of Medicare and Medicaid benefits for D-SNP enrollees.  ICRC has developed four tools for states that provide sample contract language for the minimum required SMAC elements, as well as optional elements that states can add to SMACs with D-SNPs to further state goals related to care coordination, D-SNP enrollment, reporting and information sharing, and D-SNP materials. (ICRC, January 2024)

  • Key 2023 Medicare Advantages Dates

    This resource lists several important dates related to establishing and maintaining Medicare Advantage contracts with the Centers for Medicare & Medicaid Services. States interested in contracting with D-SNPs should familiarize themselves with the key dates in this list. (ICRC, March 2023)

  • Tips to Help States Select Medicare Managed Care Authorities As They Design Integrated Care Initiatives for Dually Eligible Individuals

    This tip sheet summarizes key considerations for states trying to decide which pathway to use to advance Medicare-Medicaid integration, and which Medicaid managed care authority(ies) might best support that pathway. Although the tip sheet presents two pathways for states to consider, ultimately, a state may develop an integrated care model that falls somewhere in between these options. The Centers for Medicare & Medicaid Services (CMS) and ICRC can help each state identify a strategy that best meets its needs. (ICRC, May 2023)

  • Preventing and Addressing Unnecessary Medicaid Eligibility Churn Among Dually Eligible Individuals: Strategies for States

    This technical assistance brief summarizes steps that states can take in partnership with Dual Eligible Special Needs Plans (D-SNPs) to: (1) prevent unnecessary Medicaid eligibility loss among dually eligible populations; and (2) mitigate the impact of temporary Medicaid eligibility losses among D-SNP enrollees when such losses occur. (ICRC, March 2022)

  • State Strategies for Encouraging Enrollment in Integrated Care Programs

    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. (ICRC, August 2023)