An estimated 12.2 million people in the U.S. are eligible for both Medicare and Medicaid. A small, but growing, percentage of this population is enrolled in an integrated program that coordinates Medicare and Medicaid service delivery. These integration models include: (1) Dual Eligible Special Needs Plans (D-SNPs) that often align with Medicaid managed long-term services and supports plans; (2) federal Financial Alignment Initiative (FAI) demonstrations; and (3) Programs of All-inclusive Care for the Elderly.
While more than one-third of states currently operate a D-SNP or FAI based model, opportunities exist to both develop new programs and enhance and grow existing ones. However, to successfully operate integrated care models, states must extend their expertise beyond Medicaid and develop knowledge of Medicare’s evolving landscape of policies, regulations, and market activity. With support from Arnold Ventures, The Commonwealth Fund, and The SCAN Foundation, the Center for Health Care Strategies (CHCS) is developing a Medicare Academy for Medicaid agencies focused on building or enhancing Medicare capacity needed to advance integrated care.
Helping States Build Medicare Capacity
States working to advance integration often have limited access to Medicare-focused information and training that is both geared to state audiences and tailored to their unique policy goals and health care environments. The Medicare Academy will help participating states build the Medicare knowledge they need to: (1) develop and oversee Medicare-Medicaid integration programs; and (2) engage in longer-term policy and program refinement. To help states build this capacity, CHCS’ Medicare Academy curriculum and training materials will focus on the practical Medicare knowledge most needed by states.
Piloting a Multi- and Single-State Medicare Academy
The Medicare Academy will facilitate two different approaches to presenting the curriculum ― a longer, multi-state cohort that will promote peer-to-peer learning and a shorter, more intensive single-state Academy to support a state with its specific goals. For the multi-state cohort, CHCS will recruit up to eight states that use varying integration models and bring different levels of Medicare knowledge into the Academy’s virtual classroom. The single-state Academy will customize the curriculum to fit the needs of a state team actively refining an existing integrated care model or launching a new one. CHCS will also publicly share select Academy resources following completion of the cohorts to complement other resources that support states in building and refining integrated models.
At the completion of the pilot, participating states will be positioned to make meaningful changes to their integration policies and processes and build the infrastructure needed to sustain Medicare capacity over time. An opportunity for state teams to apply to participate in the Medicare Academy will be released in Summer 2022, with Academy sessions kicking off in Fall 2022.