A Pathway to Full Integration of Care for Medicare-Medicaid Beneficiaries
Recommended care models and policies to improve integrated care for dually eligible individuals at the state level.
Brief/Report
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Displaying 21 - 40 of 43
Serving People with Severe Mental Illness who are Dually Eligible for Medicare and Medicaid
Examines promising strategies to meet the needs of dually eligible individuals with serious mental illness, with an emphasis on opportunities to innovate with flexible spending within a capitated payment model.
Peer-Reviewed Article
Integrating Care for Dually Eligible Beneficiaries: Policy Issues and Options
Details the landscape of integrated care models and identifies policy recommendations to increase the availability of integrated care for dually eligible individuals.
Brief/Report
Integrating Care for Dually Eligible Beneficiaries: Background and Context
Summarizes the characteristics of dually eligible individuals, integrated care models, and available evidence on the impact of these models.
Brief/Report
As It Grows, Medicare Advantage Is Enrolling More Low-Income and Medically Complex Beneficiaries
The proportion of low-income, frail, and medically complex individuals enrolled in Medicare Advantage is increasing.
Brief/Report
Starting from Square One: Considerations for States Exploring Medicare-Medicaid Integration
Poses key questions to help states new to Medicare-Medicaid integration assess readiness for integration and select an achievable integration approach.
Brief/Report
The Value of Pursuing Medicare-Medicaid Integration for Medicaid Agencies
Highlights early findings demonstrating that Medicare-Medicaid integration can improve beneficiary experience and health outcomes, increase program efficiencies, and improve Medicaid program management.
Brief/Report
A Turning Point in Medicare Policy: Guiding Principles for New Flexibility Under Special Supplemental Benefits for the Chronically Ill
How to implement the new Medicare benefits.
Implementation Tool
‘Eyes in The Home’: ACOs Use Home Visits to Improve Care Management, Identify Needs, And Reduce Hospital Use
How home visits are used by ACOs to improve care, lower costs.
Peer-Reviewed Article
State Pathways to Integrated Care: Exploring Options for Medicare-Medicaid Integration
Outlines steps states can take to advance Medicare-Medicaid integration depending on policy goals, internal capacity, and delivery system structures.
Implementation Tool
The Role of Social, Cognitive, and Functional Risk Factors in Medicare Spending for Dual and Nondual Enrollees
Details how dually enrolled beneficiaries have significantly higher levels of comorbidities and higher costs of care than their non-dually enrolled counterparts.
Peer-Reviewed Article
Health Care Transformation Task Force Value Partnership Evaluation Tool
A tool for assessing readiness for value-based partnerships.
Implementation Tool
Are Medicare Advantage Plans Using New Supplemental Benefit Flexibility to Address Enrollees’ Health-Related Social Needs?
Multiple factors, including geographic variation in available resources, may limit take-up among MA plans of new benefit flexibilities.
Brief/Report
Complex Care Models to Achieve Accountable Care Readiness: Lessons from Two Community Hospitals
Case studies of two community hospitals show how to advance accountable care.
Case Example
Comparing Care for Dual-Eligibles across Coverage Models: Empirical Evidence from Oregon
Explores different characteristics of dually eligible individuals that have different coverage types, as well as the impact of aligned Medicare and Medicaid benefits to improve quality of care and utilization outcomes.
Peer-Reviewed Article
Accountable Care Atlas: A Development Guide for Competency Implementation
This resources describes the competencies organizations need to transition to value-based payment.
Implementation Tool
Bending the Spending Curve: The Role of Care Management in a Pioneer ACO
ACOs have lowered costs for high-need patients through care management programs focused on modifiable spending.
Peer-Reviewed Article
State Strategies: Value-Based Payment for Medicaid Populations with Complex Care Needs
This brief describes Medicaid payment reform strategies for long-term services and support.
Brief/Report
CareMore: Improving Outcomes and Controlling Health Care Spending for High-Needs Patients
CareMore’s business model identifies high-risk patients and surrounds them with coordinated services
Case Example
The ‘One Care’ Program at Commonwealth Care Alliance: Partnering with Medicare and Medicaid for Dual Eligibles
Examines a unique program that seeks to integrate medical, behavioral health, and social services for dual eligible individuals with serious mental illnesses, substance abuse problems, or disabilities.
Case Example