Improving the quality and cost-effectiveness of publicly financed health care
Designing Integrated Care Programs: An Online Toolkit
In December 2005, the Center for Health Care Strategies (CHCS) launched the Integrated Care Program (ICP) to promote state programs that integrate the financing, delivery, and administration of primary, acute, behavioral health, and long-term supports and services for those dually eligible for Medicaid and Medicare (as well as Medicaid-only persons with disabilities). Five states -- Florida, Minnesota, New Mexico, New York, and Washington -- were competitively selected and received technical assistance and training for the development and implementation of integrated care programs. Efforts specifically focused on planning requirements for state contracts with Medicare Advantage Special Needs Plans as well as on three state-identified priority areas: (1) administrative simplification; (2) rate setting and risk adjustment; and (3) performance measurement.
Over the two-year initiative, CHCS has collected and/or developed a number of tools and publications related to integrated care. This online toolkit is designed to facilitate the sharing of key resources that are used by, or that were developed on behalf of, the ICP states.
It is CHCS' hope that the resources provided through this toolkit will enable other states to develop their own integrated care programs.
CHCS' Integrated Care Program and Additional State Projects
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CHCS Resources
- Integrated Care Program Design: A Checklist for States (PDF)
- Integrated Care Program Development and Procurement Workplan (PDF)
- Medicare Advantage Rate Setting and Risk Adjustment: A Primer for States (PDF)
- Obtaining Medicare Advantage Bid Pricing Data From SNPs: Suggested RFP Language for State Medicaid Agencies (PDF)
- Integrated Care Program Performance Measures Recommendations (PDF)
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State Contracts
- Massachusetts Senior Care Options (PDF)
- Minnesota Senior Health Options (PDF)
- Minnesota Disability Health Options (PDF)
- New Mexico Coordinated Long-Term Services (PDF)
- New York Medicaid Advantage (PDF)
- New York Medicaid Advantage Plus (PDF)
- Washington Medicaid Integration Partnership (PDF)
- Washington Medicaid Integration Partnership: Nursing Home Risk & Payment MOU (PDF)
(The Nursing Home Risk & Payment MOU will be added to Washington's contract in the next contracting cycle.) - Washington Medicaid-Medicare Integration Program (PDF)
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State Enrollment Forms
- Massachusetts Senior Care Options (PDF)
- Minnesota Senior Health Options (PDF)
- Minnesota Disability Health Options (PDF)
- New York Medicaid Advantage (PDF)
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State Rate Setting Information
- Minnesota Senior Health Options: Rate Structure (PDF)
- New York Medicaid Advantage: Instructions and Worksheets (PDF)
- New York Medicaid Advantage Plus: Rate Proposal Instructions (PDF)
- Wisconsin Partnership Program: Rate Report 2007 (PDF)
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Additional State & Federal Resources
Member Handbooks:
- New York Medicaid Advantage Member Handbook (PDF)
- New York Medicaid Advantage Plus Member Handbook (PDF)
Functional Screens:
- Wisconsin Long Term Care Functional Screen: Overview (PDF)
- Wisconsin Long Term Care Functional Screen: Screening Tool (PDF)
Integrated Care Websites:
- CMS' Integrated Care Roadmap
- CMS' Special Needs Plan Comprehensive Report
- Florida Senior Care
- Minnesota Senior Health Options
- Minnesota Disability Health Options
- New Mexico Coordinated Long Term Services
- Washington Medicaid Integration Partnership
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