Medicaid Integration

This issue brief from the MLTSS Institute focuses on aspects of delivering effective care to individuals eligible for both Medicare and Medicaid. Only about 2/3 of states have undertaken any activity to better integrate care for dually eligible beneficiaries; many have encountered a number of barriers in pursuing better integration of the Medicare and Medicaid programs. This issue brief identifies key questions that states should ask themselves before they design an integrated care program.

This report examines how health plans can partner to promote successful integration of care for enrollees with behavioral health conditions. As part of this report, CHCS interviewed leaders of organizations that are partnering to integrate care.. The report analyzes findings from Colorado, Oregon, Arizona, And Arkansas and highlights key elements that contribute to successful partnerships between physical and behavioral health organizations.

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.

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.

In 2021, under a recently released rule from CMS, D-SNPs will be required to notify the state or state’s designee when enrollees experience Medicare-covered hospital or skilled nursing facility admissions in order to ensure timely transitions of care. The Integrated Care Resource Center has released a brief that examines approaches from three states – Oregon, Pennsylvania, and Tennessee – to develop and implement information-sharing processes for their D-SNPs that support care transitions.

CMS released an informational bulletin that provides guidance regarding new constructions and the HCBS heightened scrutiny process. The 2014 Medicaid HCBS regulation’s settings regulation requires an in-depth assessment, called heightened scrutiny, for certain providers that are presumed to be institutional. This guidance provides clarification and flexibility to states, including an overview of three potential scenarios for how newly constructed settings could receive Federal funding

While faced with new challenges, reduced budgets, and growing populations requiring more services, states are stronger than ever, and the work they do is more effective than ever in reaching individuals and addressing their needs. The National Home and Community Based Services (HCBS) Conference 2018 highlights these achievements, allowing states to share best practices, present unique partnerships, and recognize the work of their peers.

This annual report focuses on how CMS is working to improve care for Medicare-Medicaid enrollees. The report outlines the progress of CMS as it works to meet its strategic goals. It also identifies four legislative recommendations for improving care coordination and benefits.

This webinar is presented by Mark Regan and Todd Swanson from the Law Offices of Hooper Lundy & Bookman PC. Their practices are dedicated to the representation of healthcare providers and suppliers.

The Center for Health Care Strategies (CHCS) and Manatt Health has developed a new toolkit that provides a targeted menu of long-term services and supports (LTSS) reform strategies adopted by state innovators that may be replicated by other states. The toolkit identifies concrete policy strategies, operational steps, and federal and state authorities that states have used to advance their LTSS reforms.