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 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 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 care… (Integrated Care Resource Center)
This report compares utilization of community-based services by dually eligible beneficiaries enrolled in a fully integrated managed care program to those of beneficiaries receiving Medicare and Medicaid services from separate delivery systems.… (Office of the Assistant Secretary for Planning and Evaluation [ASPE])
This presentation examines strategies for states establishing Medicaid MLTSS or integrated care programs to ensure that health plans develop LTSS provider networks to address beneficiaries' diverse needs.
(Integrated Care Resource Center)
This second edition of the scorecard measures state-level performance on five dimensions: (1) affordability and access; (2) choice; (3) quality; (4) support for family caregivers; and (5) effective transitions.
(AARP Public Policy Institute)
This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage network adequacy requirements and their application to D-SNPs.
(Integrated Care Resource Center)
This report spotlights the approaches used by five states - Arizona, Minnesota, Tennessee, Texas, and Wisconsin - to ensure managed care organizations are ready to provide care coordination services to consumers and adequate access to needed long-… (AARP Public Policy Institute)
This tool is a road map for states to use in interpreting and applying existing External Quality Review protocols when assessing Medicaid MLTSS program compliance.
(Centers for Medicare & Medicaid Services)
This webinar highlights efforts in two states: (1) findings from an external evaluation in Illinois tracking the transition to MLTSS and considering home and community-based services measures as the program integrates LTSS; and (2) how New York is… (National Council on Aging)
This brief presents considerations for provider network development, reviews recent guidance, and offers examples of state practices for establishing MLTSS network adequacy standards.
(Center for Health Care Strategies)
This paper provides resources to help state advocates identify measures that can help determine if the identified needs and goals of people with disabilities and seniors are being met.
(Disability Rights Education & Defense Fund)