States seeking to integrate Medicare and Medicaid services for dually eligible beneficiaries need to consider a variety of issues in program design and implementation such as incorporating behavioral health and long-term services and supports, consumers and providers engagement, and linking Medicare and Medicaid data. Use the filter below to view resources related to these and other topics.
This fact sheet, updated in July 2019, summarizes default enrollment requirements and state roles in the default enrollment approval and implementation process. It also provides references to additional resources for more detail and… (Integrated Care Resource Center)
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… (Integrated Care Resource Center)
This Centers for Medicare & Medicaid Services (CMS) final rule strengthens patient protections, improves care coordination, and provides administrative flexibilities and regulatory relief for Programs of All-Inclusive Care for the… (Centers for Medicare & Medicaid Services)
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… (Integrated Care Resource Center)
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… (Integrated Care Resource Center)
This report provides a national overview of long-term services and supports (LTSS) rebalancing and highlights 10 states – Missouri, Massachusetts, New York, New Jersey, Connecticut, Colorado, South Carolina, Illinois, Nevada, and Arkansas… (Centers for Medicare & Medicaid Services)
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)… (Integrated Care Resource Center)
This State Medicaid Director Letter invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial… (Centers for Medicare & Medicaid Services)
This webinar describes four new quality measures specifically designed for use by Medicaid managed long-term services and supports (MLTSS) plans, which address comprehensive assessments, comprehensive care plans, shared care plans with primary… (Integrated Care Resource Center)
In 2017, there were 12 million individuals dually eligible for Medicare and Medicaid. This fact sheet provides information on their reasons for Medicare eligibility, costs of care, and enrollment in managed care as well as the… (Centers for Medicare & Medicaid Services)
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… (Centers for Medicare & Medicaid Services)
To provide more integrated, coordinated care for its residents who are dually eligible for Medicare and Medicaid, Washington State is operating a demonstration under the Financial Alignment Initiative offered by the Centers for Medicare &… (Integrated Care Resource Center)