Health plans are a key component of integrated care programs in many states. The resources in this section describe strategies that states can use when working with health plans to design and implement successful integrated Medicare-Medicaid programs.
Providing Value-Added Services for Medicare-Medicaid Enrollees: Considerations for Integrated Health Plans
Explores how health plans are addressing members’ service needs that are beyond the scope of traditionally covered Medicare or Medicaid services, as well as assessing the value of offering these services.
Ensuring Stable Housing for Medicare-Medicaid Enrollees with Long-Term Care Needs
Describes how several states are addressing the housing needs of dually eligible beneficiaries who use long-term services and supports.
Housing Options for High-Need Dually Eligible Individuals: Health Plan of San Mateo Pilot
Describes a pilot program developed by a health plan that was designed to help dually eligible individuals in nursing facilities transition back to community living and support those at risk of nursing home placement to remain in the community.
Building a Culture of Engagement for Medicare-Medicaid Enrollees: Health Plan Approaches
Outlines promising strategies that health plans can use to engage dually eligible individuals with complex medical, behavioral health, and social service needs.
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.
Engaging Providers in Building Managed Care Delivery Systems: Tips for States
Offers tips to help states effectively engage providers in managed care program design and implementation.
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.