Project Overview
To provide technical assistance and support to states and the Centers for Medicare & Medicaid Services Medicare-Medicaid Coordination Office (MMCO) regarding options for improving and integrating care for dually eligible individuals.
Despite often facing a variety of chronic conditions and functional needs, dually eligible individuals must navigate two separate, siloed systems of care in Medicare and Medicaid. The Integrated Care Resource Center project was designed to help CMS and states better integrate Medicare and Medicaid benefits to improve care for this population.
- Center for Health Care Strategies
- Infocrossing
- Institute for Exceptional Care
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Medicare - Medicaid Coordination Office
Dually eligible individuals are simultaneously low-income and over the age of 65 or under the age of 65 with disabilities. People who are dually eligible are more likely to have a disability and/or several chronic conditions than people with Medicare alone, more likely to require long-term services and supports (LTSS), and more likely to experience social and environmental risk factors that can impact health outcomes. People of color are also disproportionately represented within the dually eligible population, and more than 20% of dually eligible individuals speak limited English. Despite these challenges, dually eligible individuals must navigate two separate, siloed systems of care in Medicare and Medicaid.
It was very clear [in this presentation] that the presenters are extremely knowledgeable. It is much harder to be succinct with this type of very technical material than it is to go into detail. I thought the presenters did a really excellent job of keeping their narration high-level, while using the slides to serve as a resource for those who prefer to dig deeper at their convenience. I would highly recommend this presentation to my colleagues, and plan to do so.
Evidence & Insights From This Project
Success Begins with Selection: Tips on Assessing Bidders’ Past Performance for States Procuring Integrated Care Plans
This tip sheet is designed to help states that are planning procurements related to their integrated care programs for dually eligible individuals. It aims to help these states: (1) understand the relationship between state efforts to procure Medicaid managed care plans for these programs and the state’s D-SNP contracting strategy; (2) consider options for incorporating Medicare resources into integrated care program procurements; and (3) identify and use Medicare resources to inform state selection of Medicaid managed care plans that will cover Medicaid benefits for D-SNP enrollees. The tip sheet describes five steps that states can take when developing Medicaid managed care procurements for integrated care programs.
Learn MoreDually Eligible Individuals: The Basics
Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans
Key Policy Decisions and Considerations for States Preparing for Exclusively Aligned Enrollment
Introduction to Exclusively Aligned Enrollment
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