State Pathways to Integrated Care: Exploring Options for Medicare-Medicaid Integration

To help states explore their options for Medicare-Medicaid integration, ICRC created State Pathways to Integrated Care. This tool shares steps that states can take to advance integration, beginning with relatively simple administrative actions and moving to more advanced activities involving delivery system changes.

The tool provides key considerations and resources related to:

  • Understanding Your Dually Eligible Beneficiaries
  • Assessing Environmental Factors and Opportunities to Integrate Care
  • Addressing Foundational Issues in Integrating Care
  • Exploring Integrated Care Options
    • Using Capitated Managed Care Models
      • Managed Long-Term Services and Supports
      • Dual Eligible Special Need Plan (D-SNP) Contracting
      • Advanced D-SNP Contracting Options
      • Programs of All Inclusive Care for the Elderly (PACE)
    • Using Managed Fee-for-Service Models
      • Primary Care Case Management
      • Medicaid Health Homes

States can use this tool to explore their options and chart their
own path toward integration. ICRC is available to help to states
interested in advancing Medicare-Medicaid integration for their
dually eligible beneficiaries. For more information, see
One-on-One Technical Assistance.