States can advance integrated care in both Medicaid managed care and fee-for-service delivery systems. The resources in this section explore the different components of Medicare-Medicaid integration and considerations around the development and implementation of these models.
Update on Medicare-Medicaid Integration
Describes opportunities open to states to better integrate care for dually eligible individuals, including efforts already underway in states across the nation.
Investing in Integration: Indiana’s Long-Term Care System Redesign Focuses on Dual-Eligible Populations
Profiles Indiana’s plans to develop an integrated care program for dually eligible older adults using a new Medicaid managed long-term services and supports program.
What Works to Improve Care for Dual Eligible Individuals: An Evidence and Resource Review
Summarizes a set of curated resources to help various stakeholders better understand both the needs of the dually eligible population and emerging evidence and practical approaches for advancing Medicare-Medicaid integration.
Advancing Medicare and Medicaid Integration: Key Program Features and Factors Driving State Investment
Describes key features of effective integrated care programs and presents top policy considerations driving state investment in these programs based on the experiences of 10 states with pioneering integrated care programs.
Assessing Success in Medicare-Medicaid Integration: A Review of Measurement Strategies
Details success stories from two health plans and examines the program elements behind these successes and the potential for existing measures — as well as measures currently in development — to accurately assess the performance of integrated care programs.
Key Attributes of High-Performing Integrated Health Plans for Medicare-Medicaid Enrollees
Introduces a framework of key attributes necessary for high-performing health plans to support integrated care.
Strategies to Facilitate Managed Care Implementation for Medicare-Medicaid Enrollees
Describes two strategies -- using health plan readiness review and monitoring implementation -- used by Medicaid agencies in four states to facilitate implementation of new managed care programs.
Building State Capacity to Implement Integrated Care Programs for Medicare-Medicaid Enrollees
Examines key areas where states need to build their internal capacity as they pursue integrated care programs for dually eligible individuals.
Financial Alignment Models for Medicare-Medicaid Enrollees: Considerations for Reimbursement
Explores considerations for establishing reimbursement rates and performance incentives for the capitated and managed fee-for-service financial models.
From the Beneficiary Perspective: Core Elements to Guide Integrated Care for Dual Eligibles
Details core program design elements that are critical for achieving high-quality, patient-centered, and cost-effective care for dually eligible individuals.