Integrated Care Activities

  • Financial Alignment Demonstration: Alternative model
    Dual Eligible Special Needs Plan Contracting: Yes
    Medicaid Managed Long-Term Services: Yes
    Approved Medicaid Health Home: Yes
    Program of All-Inclusive Care for the Elderly (PACE): No

Related Resources

  • Other Resource

    State and County Data File, 2012

    The most recent demographic, enrollment, and expenditure data for dually eligible beneficiaries is in the zip file "State and County Data File 2012" found on the Medicare-Medicaid Coordination Office website. Additional data and statistical resources for the years 2007, 2008, 2009, and 2011 can be found in the Medicare-Medicaid Enrollee State Profiles. See also Defining Medicare-Medicaid Enrollees in CMS Data Sources. (Centers for Medicare & Medicaid Services)
    Topic: Data for Medicare-Medicaid Integration
  • Other Resource

    Key Demonstration Documents on the MMCO Website

    These documents, including Minnesota's proposal and evaluation design plan, are posted on the Medicare-Medicaid Coordination Office's website. (Centers for Medicare & Medicaid Services)
  • Other Resource

    Minnesota State Website

    This website provides information on the Demonstration to Align Administrative Functions for Improvements in Medicare-Medicaid Beneficiary Experience -- the alternative model demonstration in Minnesota.   (Minnesota Department of Human Services)
  • Other Resource

    Ready, Set, Go! The Readiness Review Process for Care Coordination and Provider Network Adequacy in Five States

    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-term services and supports providers. (AARP Public Policy Institute)
    Topic: Oversight and Monitoring, Provider Network Adequacy
  • Other Resource

    Report on Early Implementation of Demonstrations under the Financial Alignment Initiative

    This report describes early implementation activities occurring in the first six months of the seven financial alignment demonstrations launched as of May 1, 2014. (RTI International)
    Topic: Capitated Model, Managed Fee-for-Service Model
  • Technical Assistance Tool

    State Contracting with Medicare Advantage Dual Eligible Special Needs Plans: Issues and Options

    This tool describes how 13 states used their contracts with D-SNPs to more effectively coordinate care and services for Medicare-Medicaid beneficiaries. (Integrated Care Resource Center)
    Topic: State Contracting Strategies, Oversight and Monitoring
  • Other Resource

    Managed Care for People with Disabilities Stakeholder Meeting

    Meeting Agenda, Timeline, Map of Health Plan Options by County, Reimbursement Rates, Performance Measurement, Enrollment Data, Health Plan Presentations: PrimeWest, Cornerstone, UCare, South Country Health Alliance, Medica. (Minnesota Department of Human Services)
  • Tip Sheet

    Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Designing an Integrated Summary of Benefits Document

    This tip sheet describes how states can start to improve member materials by using contractual requirements to ensure that Medicare and Medicaid benefit information for aligned plans is incorporated into a single, streamlined Summary of Benefits (SB) document. (Integrated Care Resource Center)
    Topic: Marketing and Member Materials
  • Other Resource

    Minnesota Department of Human Services Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, 2016 MSHO/MSC+ Contract (MCO)

    (Minnesota Department of Human Services)
    Topic: State Contracting Strategies
  • CY 2019 MN MSHO Summary of Benefits (SB) model document

    (Centers for Medicare & Medicaid Services/Minnesota Department of Human Services)
    Topic: Marketing and Member Materials
  • Tip Sheet

    Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Integrating Medicaid Managed Long-Term Services and Supports into D-SNP Models of Care

    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 importance of Medicaid services to dually eligible enrollees, D-SNPs are only required to describe Medicare services in their MOCs. However, states may require D-SNPs to develop an integrated MOC that describes not just how Medicare services will be provided, but also how the plan will provide and/or coordinate Medicaid benefits. This tip sheet outlines the benefits of integrated MOCs, lists the steps in developing and implementing an integrated MOC, and provides examples of state-specific elements that Massachusetts and Minnesota require D-SNPs to include in their MOCs.   (Integrated Care Resource Center)
    Topic: Dual Eligible Special Needs Plans (D-SNPs), Models of Care, Medicaid Managed Long-Term Services and Supports (MLTSS)
  • Technical Assistance Tool

    Monthly Enrollment in Medicare-Medicaid Plans by Plan and by State, April 2021 to April 2022

    This resource reports data on the most recent 12 months of enrollment in capitated model demonstrations under the Financial Alignment Initiative. (Integrated Care Resource Center)
    Topic: Enrollment
  • Technical Assistance Tool

    State Options and Considerations for Sharing Medicaid Enrollment and Service Use Information with D-SNPs

    New federal rules released in April 2019 require that Dual Eligible Special Needs Plans (D-SNPs) must, at a minimum, coordinate the delivery of Medicare and Medicaid benefits. The final rule includes new regulatory language effective January 1, 2020 and provides examples of ways that D-SNPs should coordinate their members’ Medicare and Medicaid services. This technical assistance brief discusses issues and options for states to support D-SNPs in meeting this requirement. (Integrated Care Resource Center)
    Topic: Dual Eligible Special Needs Plans (D-SNPs), State Contracting Strategies
  • Brief

    Integrated Appeals Processes for Medicare-Medicaid Enrollees: Lessons from States

    This brief explores opportunities for states to develop an integrated appeals process, whether through a D-SNP or a financial alignment demonstration. (Center for Health Care Strategies)
    Topic: Capitated Model, Grievances and Appeals
  • Brief

    Interdisciplinary Care Teams for Medicare-Medicaid Enrollees: Considerations for States

    This brief describes key considerations for developing interdisciplinary care teams and explores how eight states addressed issues such as engaging providers and measurement approaches. (Center for Health Care Strategies)
    Topic: Assessment, Care Planning, and Care Coordination, Provider Engagement
  • Other Resource

    Minnesota Managed Care Longitudinal Data Analysis

    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. Fully integrated care was shown to yield higher beneficiary satisfaction and community-based service use when compared to the fragmented care delivery. (Office of the Assistant Secretary for Planning and Evaluation [ASPE])
    Topic: MLTSS Program Evaluation