Dual Eligibles

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Information Sharing to Improve Care Coordination for High-Risk Dual Eligible Special Needs Plan Enrollees: Key Questions for State Implementation

This technical assistance tool focuses on the new “information sharing” requirement for Dual Eligible Special Needs Plans beginning in 2021. The tool explains the new requirement as well as how to address the requirement in mandatory D-SNP contracts.

Short URL: http://www.advancingstates.org/node/71731

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File Downloads / Links

Integrated Care for People with Medicare and Medicaid: A Roadmap for Quality

To understand both the needs of people who use long-term services and supports (LTSS) through Medicare and Medicaid coverage and ways to apply quality measurement to this population, the National Committee for Quality Assurance (NCQA), supported by The SCAN Foundation, developed a roadmap for evaluating the quality of integrated care for dual eligibles.

Short URL: http://www.advancingstates.org/node/70199

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How States Can Better Understand their Medicare-Medicaid Enrollees: A Guide to Using CMS Data Resources

The CMS Medicare-Medicaid Coordination Office (MMCO) regularly reports data on Medicare-Medicaid enrollee demographics, service utilization, spending, and other characteristics that can give states a more comprehensive view of this population. This tool shows states how to use these data to create tables, graphs, and figures and interpret their meaning for a wider audience of stakeholders.

Short URL: http://www.advancingstates.org/node/70138

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Advancing Medicare and Medicaid Integration: Key Program Features and Factors Driving State Investment

For individuals who receive services from both Medicare and Medicaid, care is often fragmented across a wide array of medical, behavioral health, and long-term care providers. Medicare and Medicaid offer otherwise uncoordinated systems of care with different eligibility criteria, benefits, provider networks, and enrollment processes. This issue brief describes key features of effective integrated care programs and presents top policy considerations driving state investment in these programs.

Short URL: http://www.advancingstates.org/node/69991

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Medicaid Agency Partnerships with State Health Insurance Programs: Opportunities to Improve Care for Medicare-Medicaid Enrollees

This brief from the Integrated Care Resource Center discusses opportunities for Medicaid agencies to partner with State Health Insurance Programs (SHIPs). Every state has a SHIP that is responsible for providing counseling and assistance for people with Medicare and their families. This brief highlights approaches used by Arizona, Massachusetts, and Texas, where SHIPs and Medicaid agencies have worked together to educate Medicare-Medicaid enrollees on new care delivery options.

Short URL: http://www.advancingstates.org/node/69759

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State Insights on Refining Integrated Care for Dually Eligible Beneficiaries

This new brief, made possible by The Commonwealth Fund and The SCAN Foundation, highlights insights from states that are fine-tuning their integrated care programs. Formal evaluations of some integrated care programs are underway; however, until these results become available, the refinements made by states described in the brief -- all participants in the Implementing New Systems of Integration for Dually Eligible Enrollees (INSIDE) project.

Short URL: http://www.advancingstates.org/node/69092

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File Downloads / Links

Better Outcomes for Dually Eligible Older Adults through Integrated Care

The Department of Health and Human Services (HHS) published a report about the Minnesota Senior Health Options (MSHO) program. The Centers for Medicare and Medicaid Services (CMS) and the State of Minnesota started MSHO to coordinate the Medicare and Medicaid benefits their members receive, including Medicare coverage of acute medical care and Medicaid coverage of long-term services and supports. The report includes documentation of MSHO's outcomes from years 2010 to 2012.

Short URL: http://www.advancingstates.org/node/68017

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The Duals Demonstration: A First Glimpse at Lessons Learned

Justice in Aging published an issue brief that offers an analysis of the findings from the evaluation of the Financial Alignment Initiative (FAI), commonly known as the dual eligible demonstration. Research Triangle Institute was contracted by the Centers for Medicare and Medicaid Services (CMS) to conduct this evaluation, which focused on the first six months of operation of the demonstration in each of the seven states where it was rolled out.

Short URL: http://www.advancingstates.org/node/67477

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