Technical Assistance Tool

The Complex Art of Making It Simple: Factors Affecting Enrollment in Integrated Care Demonstrations for Dually Eligible Beneficiaries

Dually eligible beneficiaries began enrolling in integrated Medicare-Medicaid plans (MMPs) under the Financial Alignment Initiative (FAI) in calendar year 2013. Under the FAI, the Centers for Medicare & Medicaid Services (CMS) and 10 participating states contracted with MMPs under capitated arrangements to coordinate Medicare and Medicaid benefits. Beneficiary participation has been lower than anticipated. Only about 29 percent of eligible individuals enrolled in MMPs in 2017.

How States Can Better Understand their Dually Eligible Beneficiaries: A Guide to Using CMS Data Resources

This technical assistance tool shows states how to use data on Medicare-Medicaid dually eligible beneficiary demographics, service utilization, spending, and other characteristics to create tables, graphs, and figures and interpret their meaning for a wider audience of stakeholders. 

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 2020 Star Ratings are now available on CMS’ website. 

Training Enrollment Broker Call Center Staff: Tips for States Implementing Capitated Financial Alignment Demonstrations

This tool describes the key areas of information that demonstration enrollment brokers' customer service representatives should master to improve the quality of decision-support services for beneficiaries who are being passively enrolled in a Medicare-Medicaid Plan.


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