Advancing innovations in health care delivery for low-income AmericansStart: May 2013
End: December 2017
Funder: The Commonwealth Fund and The SCAN Foundation
Many of the more than 11 million individuals enrolled in both Medicare and Medicaid have complex health care needs, but receive services in separate, unaligned, and uncoordinated delivery systems. To address long-standing problems with Medicare-Medicaid integration, many states are participating in the Financial Alignment Initiative sponsored by the Centers for Medicare & Medicaid Services and others are pursuing alternative approaches to integration such as contracting with Medicare Advantage Dual Eligible Special Needs Plans.
INSIDE, supported by The Commonwealth Fund and The SCAN Foundation, supported and connected states, federal officials, health plans, and provider partners to advance models that integrate Medicare and Medicaid. Through three project phases, CHCS provided participating states with a platform for shared learning and opportunities for peer-to-peer exchange and dialogue between states and federal officials:
- INSIDE III (2017) worked with 10 states — Arizona, Illinois, Massachusetts, Minnesota, New Jersey, Ohio, Rhode Island, South Carolina, Tennessee, and Virginia — advancing Medicare-Medicaid integration through financial alignment demonstration programs and/or contracts with Dual Eligible Special Needs Plans.
- INSIDE II (2014-2017) worked with 14 states — Arizona, California, Florida, Idaho, Massachusetts, Minnesota, New Jersey, New York, Ohio, Rhode Island, South Carolina, Texas, Virginia, and Washington — that were in the implementation and oversight phase of their integrated care programs to refine and accelerate their efforts.
- INSIDE I (2013-2014) brought together 16 states — Arizona, Arkansas, California, Colorado, Idaho, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, Pennsylvania, Rhode Island, South Carolina, Texas, Virginia, and Washington — to help them design and launch integrated care programs or other innovations for Medicare-Medicaid enrollees.
The tools and resources developed to support the states participating in INSIDE were disseminated broadly to help additional states pursue integrated care for Medicare-Medicaid enrollees.
Related Resources
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BriefAdvancing Medicare and Medicaid Integration: Key Program Features and Factors Driving State Investment November 2017
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InfographicAdvancing Medicare and Medicaid Integration November 2017
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Fact SheetUpdate on Medicare-Medicaid Integration March 2017
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BriefState Insights on Refining Integrated Care for Dually Eligible Beneficiaries December 2016
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BriefState Trends in the Delivery of Medicaid Long-Term Services and Supports July 2016
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Technical Assistance BriefInterdisciplinary Care Teams for Medicare-Medicaid Enrollees: Considerations for States January 2016
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Technical Assistance BriefCommunicating Early Results of Integrated Care Efforts for Dually Eligible Individuals: State Approaches January 2016
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Technical Assistance BriefSnapshot of Integrated Care Models to Serve Dually Eligible Beneficiaries December 2015
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Technical Assistance BriefIntegrated Appeals Processes for Medicare-Medicaid Enrollees: Lessons from States January 2015
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Technical Assistance BriefRisk Stratification to Inform Care Management for Medicare-Medicaid Enrollees: State Strategies November 2014
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WebinarDemonstrations to Improve Care for Dually Eligible Beneficiaries: State Perspectives on Year 1 October 2014
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WebinarEngaging Medicare-Medicaid Enrollees: Insights from Three Financial Alignment Demonstration States August 2014
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Technical Assistance BriefStrategies to Facilitate Managed Care Implementation for Medicare-Medicaid Enrollees June 2014
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Technical Assistance ToolEngaging Providers in Building Managed Care Delivery Systems: Tips for States April 2014
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BriefState Approaches to Integrating Physical and Behavioral Health Services for Medicare-Medicaid Beneficiaries: Early Insights February 2014
Lead Staff
- Alexandra KruseAssociate Director, Medicare-Medicaid Alignment