Integrated Care

On December 16, 2021 ATI Advisory released a report titled Modernizing California’s Health Insurance Counseling & Advocacy Program (HICAP): Strategy Recommendations. HICAP is the State Health Insurance Assistance Program (SHIP) in the state of California, which is run by the California Department of Aging (CDA).

NCOA, in partnership with the Medicare Rights Center, recently expanded the resources in their toolkit that help explain integrated care coverage options for dual eligibles. New items in the toolkit include a video tutorial explaining integrated care, an infographic for counselors, and comparison charts highlighting the differences between Original Medicare, PACE, Duals Special Needs Plans (D-SNPs) and integrated D-SNPs.

ATI Advisory released extensive data analysis of Medicare claims data to highlight the disparate impact of the COVID-19 pandemic on individuals eligible for both Medicare and Medicaid (dual eligibles).The analysis also offers policy pathways for states to improve integrated care for this vulnerable population.

This issue brief from the MLTSS Institute focuses on aspects of delivering effective care to individuals eligible for both Medicare and Medicaid (dually eligible individuals).The brief provides a primer on the ways that Medicare data can help states better deliver care to dually eligible individuals; it also details information about data sources and other resources available to help obtain and analyze Medicare data.

The MACPAC June 2020 Report to Congress on Medicaid and CHIP was created prior to the COVID-19 pandemic and highlights long-term challenges facing Medicaid. Across six chapters, it discusses key issues including integrated care for dually eligible Medicaid and Medicare beneficiaries, Medicare Savings Programs, and Medicaid's statutory role as the payer of last resort.

This webinar discussed two issue briefs from the MLTSS Institute on aligning Medicare and Medicaid for dually eligible individuals. The briefs covered were, "Starting from Square One: Considerations for States Exploring Medicare-Medicaid" and, “The Value of Integration to State Medicaid Agencies”. The webinar also highlighted the perspective of the District of Columbia, which is planning to launch new program elements to better integrate care.

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.

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.

This brief summarizes how recent changes to Medicare Advantage may enable AAAs and other CBOs to form new partnerships with Medicare Advantage plans. These partnerships can be used to provide supplemental benefits, such as home-delivered meals and transportation, to beneficiaries. The updated brief covers additional guidance from CMS on the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act.

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.