Dual Eligibles -Integrated Program Details

  
     Dual Eligibles -Integrated Program Details CMS has several programs that encourage states to provide integrated care, a concept that provides the full array of Medicaid and Medicare benefits through a single delivery system in order to provide quality care for dual eligible enrollees, improve care coordination, and reduce administrative burdens. For more information on each program, click below: Program of All Inclusive Care for the Elderly (PACE) State Option to Provide Health Homes for Enrollees with Chronic Conditions More information on Medicare and Medicaid Enrollees. Development and Design Guidance tools like the Integrated Care Roadmap include: "At-A-Glance" Guide to Medicaid Authorities Available to States for Integrated Programs Medicaid and Medicare Authorities to Implement Long-Term Care Capitation Models Integrated Care Program Design Center for Health Care Strategies Rate Setting and Risk Adjustment: A Checklist for States Information regarding Optional Models for an Integrated Medicaid and Medicare Appeals Process for Special Needs Plans includes: Integrated Appeals Process Standard Appeal Flowchart Expedited Appeal Flowchart Medicare Advantage Center for Health Care Strategies Primer Medicare Advantage Application for Special Needs Plans Cost Sharing Information regarding Medicaid's obligation to pay cost-sharing for individuals who are eligible for both Medicare and Medicaid and who are enrolled in Medicare Advantage Plans: Center for Health Care Strategies Primer on Medicare Rate Setting and Risk Adjustment CMS Medicare Advantage Application for Special Needs Plans Additional Guidance on the Medicare Advantage Program and Special Needs Plans The Medicare Managed Care Manual provides additional information and guidance on the Medicare Advantage Program. Additional information on Special Needs Plans.