Dual Eligibles

File Downloads / Links

Facilitating Community Transitions for Dually Eligible Beneficiaries

This case study explores how health plans can help rebalance LTSS for dually eligible members. It looks at two California health plans who successfully transitioned dually eligible members from institutional to community settings. The case study uses these two examples to identify key elements for supporting dually eligible individuals with LTSS needs during the transition to living in the community.

Short URL: http://www.advancingstates.org/node/71856

File Downloads / Links

The Value of Pursuing Medicare-Medicaid Integration for Medicaid Agencies

This report is the fourth in a series of publications from the MLTSS Institute, which was established in 2016 to drive improvements in key MLTSS policy areas, facilitate sharing and learning among states, and provide direct and intensive technical assistance to states and health plans. This issue brief focuses on delivering effective care to individuals eligible for both Medicare and Medicaid and aims to lay out the case for state Medicaid agencies to invest in integrated care programs.

Short URL: http://www.advancingstates.org/node/71835

File Downloads / Links

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

File Downloads / Links

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

File Downloads / Links

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

File Downloads / Links

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

File Downloads / Links

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

File Downloads / Links

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

File Downloads / Links

Pages

Subscribe to RSS - Dual Eligibles