With support from MACPAC, Mathematica studied state D-SNP contracting strategies aimed at integrating Medicare and Medicaid. A report and issue brief summarize key findings, including the importance of state context and resources; challenges in rural areas; and considering potential trade-offs and unintended...
Related Content
Related Publications for
-
Advancing Integrated Care for Dually Eligible Individuals: Factors Influencing State D-SNP Contracting DecisionsJul 20, 2021
-
State Options and Considerations for Sharing Medicaid Enrollment and Service Use Information with D-SNPsDec 31, 2019
This technical assistance brief describes four options that states can use, individually or concurrently, to provide information to D-SNPs on their dually eligible members’ Medicaid plan enrollment and/or service use.
-
Background Information on Integration and Medicaid MLTSS Market Trends for Panel Discussion on How States Are Positioning for Integration (Presentation)Oct 18, 2018
In this presentation, prepared as background for a panel discussion titled "How Are States Positioning for Integration," reviews market trends for Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) that provide integrated Medicare and Medicaid services for beneficiaries dually eligible for...
-
Preventing Improper Billing of Medicare-Medicaid Enrollees in Managed Care: Strategies for States and Dual Eligible Special Needs PlansFeb 28, 2018
This brief describes the ongoing problem of improper billing of protected dually eligible beneficiaries for Medicare cost-sharing and describes steps states and health plans can take to address it.
-
Value-Based Payment in Nursing Facilities: Options and Lessons for States and Managed Care PlansNov 06, 2017
To improve the value of care provided in nursing facilities, payers are experimenting with value-based payment (VBP) approaches that link financial rewards to measures of quality.
-
Integrating Behavioral and Physical Health for Medicare-Medicaid Enrollees: Lessons for States Working With Managed Care Delivery SystemsAug 31, 2017
This brief explores the experience of six states that have achieved varying levels of behavioral health and physical health integration or coordination for dually eligible beneficiaries in a managed care environment.
-
Other State Approaches to Integrating Medicare and Medicaid for Dually Eligible Beneficiaries: Implications for the New York State FIDA DemonstrationJul 20, 2017
This presentation highlights national trends and patterns in integrating Medicare and Medicaid services for beneficiaries dually eligible for both programs.
-
State and Health Plan Strategies to Grow Enrollment in Integrated Managed Care Plans for Dually Eligible BeneficiariesJun 13, 2017
This brief outlines strategies that states and health plans can use to grow their enrollment in Integrated Managed Care Plans for Dually Eligible Beneficiaries.
-
State Contracting with Medicare Advantage Dual Eligible Special Needs Plans: Issues and OptionsNov 30, 2016
Dual Eligible Special Needs Plans (D-SNPs) are a type of Medicare Advantage plan that serve beneficiaries dually enrolled in Medicare and Medicaid.
-
Getting the Mix Right: Pricing, Benefits, and Risk Adjustment for Dual EligiblesNov 19, 2015
Presentation for the Dual Eligibles Program Leadership Forum.
-
Reducing Avoidable Hospitalizations for Medicare-Medicaid Enrollees in Nursing Facilities: Issues and Options for StatesApr 30, 2015
States that contract with health plans to provide comprehensive Medicare and Medicaid services for dually eligible enrollees in nursing facilities can work with these plans to reduce avoidable hospitalizations.
-
State Monitoring and Oversight of Managed Long-Term Services and Supports Care ProgramsSep 23, 2014
This presentation will inform states pursuing integrated care and managed long-term services and supports (MLTSS) programs about key oversight practices across states with MLTSS.
-
Improving Coordination of Home Health Services and Durable Medical Equipment for Medicare-Medicaid Enrollees in the Financial Alignment InitiativeApr 30, 2014
This technical assistance brief explores ways of improving the coordination of these overlapping benefits in the Centers for Medicare & Medicaid Services (CMS) Financial Alignment Initiative’s capitated model demonstrations.
-
Medicare Part D Prescription Drug Coverage for Medicare-Medicaid Enrollees in the Capitated Financial Alignment DemonstrationMar 30, 2013
This technical assistance brief, prepared for the Integrated Care Resource Center, provides basic information for states participating in the Centers for Medicare & Medicaid Services’ capitated Financial Alignment Demonstration covering Medicare-Medicaid enrollees.
-
Trends and Patterns in the Use of Prescription Drugs Among Medicaid Beneficiaries: 1999 to 2009Mar 30, 2013
This brief presents noteworthy trends and patterns in the use and costs of prescription drugs for Medicaid beneficiaries from 1999 to 2009. It builds on previous annual tables and chartbooks, and describes trends in drug usage and costs.
-
Report to the Congress on Medicaid and CHIPMar 15, 2013
This report was produced by the Medicaid and CHIP Payment and Access Commission (MACPAC) to communicate to Congress their key Medicaid and CHIP program administration priorities for 2013.
-
Integrating Care for Medicare-Medicaid Enrollees Using a Managed Fee-for-Service ModelFeb 28, 2012
This brief from the Integrated Care Resource Center (ICRC) reviews primary care case management and related FFS models to gather insights into key program design elements needed to manage care for high-need, high-cost beneficiaries with multiple conditions.
-
Integrating Care for Dual Eligibles in New York: Issues and OptionsFeb 01, 2012
This report for the New York State Health Foundation provides recommendations for New York State as it works to improve the coordination and integration of care dual eligibles receive through Medicare and Medicaid.
-
State Options for Integrating Physical and Behavioral Health CareOct 30, 2011
This brief explores promising state options for integrating physical and behavioral health services for high-need, high-cost Medicaid populations within a variety of care management delivery systems.
-
Leading the Way: Maine's Initial Experience in Expanding Coverage Through Dirigo Health ReformsDec 30, 2007
Since enacting comprehensive health care reform in 2003, Maine's Dirigo Health program has helped expand coverage for low- and moderate-income individuals.