This website provides information on the Demonstration to Align Administrative Functions for Improvements in Medicare-Medicaid Beneficiary Experience -- the alternative model demonstration in Minnesota.
(Minnesota Department of Human Services)
The most recent demographic, enrollment, and expenditure data for dually eligible beneficiaries is in the zip file "State and County Data File 2012" found on the Medicare-Medicaid Coordination Office website. Additional data and statistical resources for the years 2007, 2008, 2009, and 2011 can be found in the Medicare-Medicaid Enrollee State Profiles. See also Defining Medicare-Medicaid Enrollees in CMS Data Sources.
(Centers for Medicare & Medicaid Services)
These documents, including Minnesota's proposal and evaluation design plan, are posted on the Medicare-Medicaid Coordination Office's website.
(Centers for Medicare & Medicaid Services)
Meeting Agenda, Timeline, Map of Health Plan Options by County, Reimbursement Rates, Performance Measurement, Enrollment Data, Health Plan Presentations: PrimeWest, Cornerstone, UCare, South Country Health Alliance, Medica.
(Minnesota Department of Human Services)
This tip sheet describes how states can start to improve member materials by using contractual requirements to ensure that Medicare and Medicaid benefit information for aligned plans is incorporated into a single, streamlined Summary of Benefits (SB) document.
(Integrated Care Resource Center)
Dual Eligible Special Needs Plans (D-SNPs) must develop a model of care (MOC) that describes their enrollees’ characteristics and health and service needs as well as the plan’s care coordination and health risk assessment processes. Despite the importance of Medicaid services to dually eligible enrollees, D-SNPs are only required to describe Medicare services in their MOCs. However, states may require D-SNPs to develop an integrated MOC that describes not just how Medicare services will be provided, but also how the plan will provide and/or coordinate Medicaid benefits. This tip sheet outlines the benefits of integrated MOCs, lists the steps in developing and implementing an integrated MOC, and provides examples of state-specific elements that Massachusetts and Minnesota require D-SNPs to include in their MOCs.
(Integrated Care Resource Center)
Topic: Dual Eligible Special Needs Plans (D-SNPs), Medicaid Managed Long-Term Services and Supports (MLTSS), Assessment, Care Planning, and Care Coordination
New federal rules released in April 2019 require that Dual Eligible Special Needs Plans (D-SNPs) must, at a minimum, coordinate the delivery of Medicare and Medicaid benefits. The final rule includes new regulatory language effective January 1, 2020 and provides examples of ways that D-SNPs should coordinate their members’ Medicare and Medicaid services. This technical assistance brief discusses issues and options for states to support D-SNPs in meeting this requirement. In particular, this brief describes four options that states can use, individually or concurrently, to provide information to D-SNPs on their dually eligible members’ Medicaid plan enrollment and/or service use.
(Integrated Care Resource Center)
Topic: Dual Eligible Special Needs Plans (D-SNPs), State Contracting Strategies
This brief explores opportunities for states to develop an integrated appeals process, whether through a D-SNP or a financial alignment demonstration.
(Center for Health Care Strategies)
This brief describes key considerations for developing interdisciplinary care teams and explores how eight states addressed issues such as engaging providers and measurement approaches.
(Center for Health Care Strategies)
Topic: Assessment, Care Planning, and Care Coordination, Provider Engagement
This report compares utilization of community-based services by dually eligible beneficiaries enrolled in a fully integrated managed care program to those of beneficiaries receiving Medicare and Medicaid services from separate delivery systems. Fully integrated care was shown to yield higher beneficiary satisfaction and community-based service use when compared to the fragmented care delivery.
(Office of the Assistant Secretary for Planning and Evaluation [ASPE])
This report spotlights the approaches used by five states - Arizona, Minnesota, Tennessee, Texas, and Wisconsin - to ensure managed care organizations are ready to provide care coordination services to consumers and adequate access to needed long-term services and supports providers.
(AARP Public Policy Institute)
Topic: Oversight and Monitoring, Provider Network Adequacy
This report describes early implementation activities occurring in the first six months of the seven financial alignment demonstrations launched as of May 1, 2014.
(RTI International)
Topic: Capitated Model, Managed Fee-for-Service Model