Foundational Steps

Fillable Tables for States Assessing the Fiscal Viability of a Medicare Part A Buy-in Agreement

States may execute a Medicare Part A buy-in agreement with the Centers for Medicare & Medicaid Services (CMS) to facilitate access to Medicare Part A and dual eligible status under the Qualified Medicare Beneficiary (QMB) eligibility group. This access is beneficial to individuals and could also reduce administrative burden and costs for providers and states. However, as of November 2021, fourteen states do not have a Part A buy-in agreement.

Assessing the Fiscal Viability of a Medicare Part A Buy-in Agreement in Group Payer States

States may execute a Medicare Part A buy-in agreement with the Centers for Medicare & Medicaid Services (CMS) to facilitate access to Medicare Part A and dual eligible status under the Qualified Medicare Beneficiary (QMB) eligibility group. This access is beneficial to individuals and could also reduce administrative burden and costs for providers and states. However, as of November 2021, fourteen states do not have a Part A buy-in agreement.

State Pathways to Integrated Care

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

Alignment of Medicare Savings Program Eligibility with the Medicare Part D Low Income Subsidy Program

The Medicare Savings Programs (MSPs) are Medicaid programs (or categories of Medicaid eligibility) that provide payment for Medicare premiums and/or cost sharing for low-income individuals. This tip sheet details one way a state can improve the MSP eligibility determination process by aligning its MSP eligibility criteria with those used for the Medicare Part D Low-Income Subsidy (LIS) program to facilitate the use of LIS eligibility data in determining eligibility for MSPs.

Integrated Care Updates - April 2019

April 2019 Contents:

  • MACPAC Study on Care Coordination in Integrated Programs Serving Dually Eligible Beneficiaries

  • New CMS Initiative to Reform Primary Care Payment

  • Comment Period Extended for the Programs of All-Inclusive Care for the Elderly (PACE) 2020 Audit Protocol

  • Opportunities to Support Enrollment in the Medicare Savings Programs and Extra Help

  • Upcoming CMS Webinars on Medicaid Managed Long-Term Services and Supports

Part A Buy-in Agreements for States - Q&A

This document provides answers to states' frequently asked questions about Medicare Part A Buy-in. It describes the advantages to states of having a Buy-in agreement and how these agreements can help to promote access to integrated care for dually eligible individuals.

Building a Stronger Foundation for Medicare- Medicaid Integration: Opportunities in Modifying State Administrative Processes

This brief describes several administrative changes that state Medicaid programs can make to: (1) support integration efforts; (2) improve beneficiaries’ experience of care; (3) decrease beneficiary out-of-pocket costs; and (4) reduce provider burden. Taking the steps described in this brief may help states build stronger, more effective integrated care programs and better position them to implement larger-scale integration efforts for their dually eligible populations.