Models of Care

New ICRC Resource | Information Sharing to Improve Care Coordination for High-Risk Dual Eligible Special Needs Plan Enrollees: Key Questions for State Implementation

This technical assistance tool describes key issues states will want to address as they work with D-SNPs and other parties to design and implement information-sharing requirements. The tool includes model D-SNP contract language states can adapt for inclusion in their D-SNP contracts. Because D-SNPs must submit their 2021 contracts to CMS by early July 2020, all states should begin to consider the new information sharing requirements now in order to have sufficient time to develop new contract language and processes for 2021.

Integrated Care Updates - June 2019

June 2019 Contents:

  • MedPAC June Report to Congress Reviews D-SNPs and Discusses Policy Options for Improved
    Integration with Medicaid
  • ASPE Releases Two Reports on Dual Eligibility
  • ACL Releases a New Alzheimer’s and Dementia Program Cooperative Agreement Grant Opportunity
  • June 2019 Enrollment in Medicare-Medicaid Plans
  • June 2019 Enrollment in PACE Organizations
  • New Resources on the ICRC Website
  • Key Upcoming Dates

Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Integrating Medicaid Managed Long-Term Services and Supports into D-SNP Models of Care

This new ICRC tip sheet, part of the "Tips to Improve Medicare-Medicaid Integration Using D-SNPs" series, 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 Updates - July 2019

July 2019 Contents:

  • New MACPAC Brief on Evaluations of Integrated Care Models
  • State Data Profile Request Form
  • Upcoming Resources for Integrated Care Webinars
  • Upcoming Medicaid Webinars
  • MedPAC Data Book on Medicare Spending
  • July 2019 Enrollment in Medicare-Medicaid Plans
  • July 2019 Enrollment in PACE Organizations
  • New Resources on the ICRC Website
  • Key Upcoming Dates

Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Integrating Medicaid Managed Long-Term Services and Supports into D-SNP Models of Care

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.

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