Helping states develop integrated programs for individuals who are dually eligible for Medicare and Medicaid
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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 context.
(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)
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… (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 Elderly (PACE… (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 MSP… (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 State Data… (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 – that… (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) publicly… (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 Alignment… (Centers for Medicare & Medicaid Services)