Oversight and Monitoring

Webinar Resources | D-SNP Performance Monitoring and Oversight

On April 18, 2019, ICRC hosted a Study Hall Call on “D-SNP Performance Monitoring and Oversight: State Experiences and CMS Resources” that highlighted ways for states to begin or improve their oversight of Dual Eligible Special Needs Plans (D-SNPs). In this webinar, presenters give an overview of the Centers for Medicare & Medicaid Services’ (CMS) publicly available D-SNP performance monitoring resources and share approaches used by Oregon and Tennessee to incorporate performance monitoring and oversight requirements into D-SNP contracts.

D-SNP Performance Monitoring and Oversight: State Experiences and CMS Resources

Study Hall Call
04/18/2019

This webinar covers resources and strategies available to states to begin or improve their oversight of Dual Eligible Special Needs Plans (D-SNPs). Presenters provide an overview of the Centers for Medicare & Medicaid Services’ (CMS) publicly available D-SNP performance monitoring resources and share approaches used by Oregon and Tennessee to incorporate performance monitoring and oversight requirements into D-SNP contracts.

How States Can Use Medicare Advantage Star Ratings to Assess D-SNP Quality and Performance

The Centers for Medicare & Medicaid Services (CMS) uses a five-star quality rating system to evaluate the performance of Medicare Advantage (MA) health plans. This Star Rating system enables beneficiaries, payers, and others to compare plans across multiple dimensions. CMS publishes the Star Ratings each year – usually in October -- to help beneficiaries find the best plan for them and to determine MA quality bonus payments to plans. The lowest-ranking plans receive one star, and the highest ranking plans receive five stars. The 2019 Star Ratings are now available on CMS’ website. 

Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Using Medicare Program Audit Reports to Improve Managed Care Organization Oversight

This tip sheet describes how states can use the results of Medicare program audits to identify performance issues impacting dually eligible beneficiaries’ receipt of care coordination, long-term services and supports, durable medical equipment, and other services, and incorporate that information into their audit and oversight activities.

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