Integrated Care

This brief outlines lessons from the Center for Health Care Strategies’ MassHealth Care Planning Learning Collaborative, where Massachusetts Accountable Care Organizations and Community Partners integrated care planning across their organizations to improve care for Medicaid members with complex needs. This brief can inform providers, payers, and community partners in other states seeking to improve care for people with complex health and social needs.

In this blog post, Nancy Archibald, MHA, MBA, Associate Director of Integrated Care at CHCS, describes the state of Indiana's plan to launch Medicaid managed long-term services and supports in 2024. The state is receiving grant funding through Advancing Medicare & Medicaid Integration, an Arnold Ventures initiative developed in partnership with CHCS that assists states in filling resource gaps in designing and launching integrated care programs.

NCOA has partnered with the Medicare Rights Center to develop a toolkit for counselors who work with dual eligibles and beneficiaries. The toolkit includes a break down of coverage options in an easy-to-understand format for counselors and consumers. This toolkit was created following interviews and focus groups with counselors, and will be updated and enhanced with additional materials on an ongoing basis.

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 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 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.

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.