Data for Medicare-Medicaid Integration

Using Medicare Modernization Act (MMA) Files to Identify Dually Eligible Individuals

States need to be able to identify individuals who are (or will become) dually eligible for several reasons. Since 2005, states have exchanged files  -- known as the Medicare Modernization Act (MMA) files -- with the Centers for Medicare & Medicaid Services (CMS) that identify current and prospective dually eligible individuals. This technical assistance tools explains how states can identify Medicaid enrollees who are currently dually eligible, as well as Medicaid enrollees who will become dually eligible in the next three months (known as “prospective” dually eligible individuals) tho

State Guide to Identifying Aligned Enrollees: How to Find Medicare Plan Enrollment for Dually Eligible Individuals in Medicaid Managed Care Plans

States can advance integrated care for dually eligible individuals by promoting aligned enrollment in Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) and Medicaid managed care plans owned by the same parent company (“affiliated” plans). Dually eligible individuals who receive Medicare and Medicaid coverage from affiliated plans can benefit from improved integration of benefits and care coordination.

Using Medicare Data to Support Integrated Care for Dually Eligible Beneficiaries

Study Hall Call
05/21/2019

This webinar describes what Medicare and Medicaid data are publicly available and some simple tools that states can use to begin to explore these data. For states that are ready to undertake more in-depth analyses of Medicare data, the State Data Resource Center describes no-cost technical assistance resources that can help states to access, analyze, and interpret Medicare data.

How States Can Better Understand their Dually Eligible Beneficiaries: A Guide to Using CMS Data Resources

This technical assistance tool shows states how to use data on Medicare-Medicaid dually eligible beneficiary demographics, service utilization, spending, and other characteristics to create tables, graphs, and figures and interpret their meaning for a wider audience of stakeholders. 

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