Integrated Care

Representatives of the Western New York Integrated Care Collaborative discuss a report that their collaborative has published entitled Community Based Integrated Care Networks.

This webinar, part of a series supported by the Administration for Community Living’s (ACL) Business Acumen Learning Collaborative , focuses on looking at how the type of data that is collected by a community-based organization (CBO) can be used to help develop a value proposition to potential health care partners and payers. In an era of accountable and metric-driven care and reimbursement, collecting and analyzing data is a critical skill for any organization.

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.

This interactive session, from n4a’s 2016 annual conference, helped participants learn how to tell their organization’s story and package their “products” in ways that will help them get noticed and appreciated by health care payers. Presenters included representatives from health plans who discussed what they look for in a “pitch” from a community-based organization seeking to market its services.

This brief from the SCAN Foundation summarizes lessons learned and offers recommendations for improving integrated systems of care for people with Medicare and Medicaid, also known as dually eligible individuals. The brief draws from three years of California’s Cal MediConnect evaluation results.

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.

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.

The Center for Health Care Strategies (CHCS), in partnership with Mathematica Policy Research and Airam Actuarial Consulting, released an issue brief on the state considerations when setting capitation rates for Medicaid Managed Long-Term Services and Supports (MLTSS) programs. CHCS and its partners examined the considerations taken by eight states (Arizona, Kansas, Massachusetts, Minnesota, Tennessee, Texas, Virginia, and Wisconsin) as they established their MLTSS rates.

CMS developed a web page of resources for integrated care available for health plans and providers. CMS has been supporting efforts to build provider and health plan capacity to deliver more integrated and coordinated care to Medicare-Medicaid enrollees. These resources are targeted to various types of organizations, including behavioral health providers, health plans, long-term service & support providers. Review the technical assistance and actionable tools developed.