Dual Eligibles

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State Efforts to Integrate Care for Dually Eligible Beneficiaries: 2020 Update

This brief looks at states who operate Medicare-Medicaid integrated care models based on demonstrations under the federal Financial Alignment Initiative (FAI) or through Dual Eligible Special Needs Plans (D-SNPs) that are aligned with Medicaid managed care plans. It explores factors that contributed to state investment and successful program implementation. The brief also provides an overview of opportunities for other states interested in creating or enhancing integrated care programs.

Short URL: http://www.advancingstates.org/node/71952

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Improving Care And Managing Costs For Dual Eligibles

This report presents highlights from a National Governor's Association Roundtable held in December 2018. At the roundtable, state and federal officials, national experts, and industry and consumer experts discussed challenges and opportunities for states to improve care and manage costs for dual eligibles. Based on the conversation at this event, NGA identifies key considerations for governors and their staff.

Short URL: http://www.advancingstates.org/node/71949

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Coordinating Physical and Behavioral Health Services for Dually Eligible Members with Serious Mental Illness

This case study examines the benefits of coordinating care for dually eligible members with serious mental illness. It looks specifically at how one Pennsylvania plan used a robust care coordination and member engagement model to successfully reduce urgent and unplanned inpatient admissions; and optimize health outcomes, quality of life, and self-management skills for individuals with serious mental illness.

Short URL: http://www.advancingstates.org/node/71857

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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

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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

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Enticing Dually Eligible Beneficiaries to Enroll in Integrated Care Plans

The Financial Alignment Initiative (FAI) is intended to improve the quality of care and reduce spending for low-income people who are dually eligible. Mathematica researchers conducted a study to identify reasons for the varying participation rates across states. This brief explores the details of two major factors: passive enrollment and demonstration/MLTSS alignment.

Short URL: http://www.advancingstates.org/node/71771

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HCBS Conference 2019- Presentations

The Home and Community Based Services (HCBS) Conference is hosted annually by ADvancing States (formerly known as NASUAD). This event highlights best practices from across the country in home and community-based services. The conference includes federal, state, and local policymakers as well as those who administer, manage, and deliver waiver and other HCBS programs. This link contains all of the slide presentations from the 2019 HCBS Conference.

Short URL: http://www.advancingstates.org/node/71741

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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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