Integrated Care Activities

  • Financial Alignment Demonstration: Capitated model
    Dual Eligible Special Needs Plan Contracting: Yes
    Medicaid Managed Long-Term Services: No
    Approved Medicaid Health Home: No
    Program of All-Inclusive Care for the Elderly (PACE): Yes

Related Resources

  • Other Resource

    State and County Data File, 2012

    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)
    Topic: Data for Medicare-Medicaid Integration
  • Other Resource

    Key Demonstration Documents on the MMCO Website

    These documents, including South Carolina's proposal, three-way contract, readiness review tool, and evaluation design plan, are posted on the Medicare-Medicaid Coordination Office's website. (Centers for Medicare & Medicaid Services)
  • Other Resource

    South Carolina State Website

    This website provides information on Healthy Connections Prime -- the capitated model Financial Alignment Initiative in South Carolina. (South Carolina Department of Health and Human Services)
  • Brief

    Communicating Early Results of Integrated Care Efforts for Dually Eligible Individuals: State Approaches

    This brief describes approaches that states have used to communicate early integrated care program results. Strategies discussed include developing program indicator dashboards, disseminating beneficiary experience data, and sharing success stories. (Center for Health Care Strategies)
    Topic: Capitated Model, Quality and Performance Measurement, Beneficiary Engagement, Counseling, and Support, Provider Engagement
  • Technical Assistance Tool

    Monthly Enrollment in Medicare-Medicaid Plans by Plan and by State, January 2018 to January 2019

    This resource reports data on the most recent 12 months of enrollment in the capitated model financial alignment demonstrations. (Integrated Care Resource Center)
    Topic: Enrollment
  • Technical Assistance Tool

    Monthly Enrollment in Medicare-Medicaid Plans by Plan and by State, October 2019 to October 2020

    This resource reports data on the most recent 12 months of enrollment in capitated model demonstrations under the Financial Alignment Initiative. (Integrated Care Resource Center)
    Topic: Enrollment
  • Technical Assistance Tool

    Monthly Enrollment in Medicare-Medicaid Plans by Plan and by State, April 2020 to April 2021

    This resource reports data on the most recent 12 months of enrollment in capitated model demonstrations under the Financial Alignment Initiative. (Integrated Care Resource Center)
    Topic: Enrollment
  • Brief

    State Approaches to Developing and Operating Ombudsman Programs for Demonstrations under the Financial Alignment Initiative

    Ombudsman programs can offer beneficiary protections as part of Medicaid managed care programs. These programs are particularly important for beneficiaries with complex physical and behavioral health conditions, including many dually eligible individuals. For the demonstrations under the Financial Alignment Initiative, the Centers for Medicare & Medicaid (CMS) and states incorporated ombudsman programs to help to resolve enrollees’ problems and alert Medicare-Medicaid Plans (MMPs), states, and CMS of emerging trends and issues. This technical assistance brief compares approaches that states took in structuring ombudsman programs and discusses the benefits and challenges of both models. It also examines the services offered by ombudsman programs and the value these programs have brought to the demonstrations. This brief is designed to help state Medicaid agencies that are developing beneficiary support systems or implementing new integrated care programs to better understand the full range of beneficiary needs within their dually eligible populations and how ombudsman programs or similar support systems could bring value to their efforts. (Integrated Care Resource Center)
    Topic: Financial Alignment Demonstrations, Quality and Performance Measurement, Background on Long-Term Services and Supports, Assessment, Care Planning, and Care Coordination