1. Duals Integration Across the Spectrum
Michelle Herman Soper
Director of Integrated Care, Center for Health Care Strategies
NAMD Fall 2018 Meeting
November 14, 2018

2. State Integration Models
Financial Alignment Initiative demonstrations
Medicaid managed long-term services and supports (MLTSS) as a building block
Medicare Advantage Dual Eligible Special Needs Plans (D-SNP) contracting
Fully Integrated (FIDE) D-SNPs
Program of All-Inclusive Care for the Elderly (PACE)

3. Significant Growth in Integrated Care Programs for Dually Eligible IndividualsLA CA MT WI MI SC NC VA WV WA IA OR NV ID WY NE UT AZ NM CO SD ND MN KS OK TX MO AR MS AL GA FL IL IN OH KY TN ME NY PA VT NH MA RI CT NJ DE MD DC AK HI
up from 3 states (MA, MN, WI) in 2009
“Integrated SNP Program” and “Partially Integrated SNP Program” enrollment includes programs in which a Medicare-Medicaid enrollee receives both Medicare and Medicaid services from companion or aligned Medicare D-SNPs and Medicaid managed care plans. integrated care and/or financing models
Many enrollees in less integrated programs that have some level of alignment above the minimum
State Integrated/Aligned Programs in 2018
Estimated enrollment in integrated care programs: nearly 800,00 nationally

4. Select Resources for States to Support Integration
Integrated Care Resource Center (ICRC) (in partnership with Mathematica Policy Research)
State Pathways to Integrated Care shares steps that states at all points can take to advance integration
Working with Medicare Webinars provide information for states about managing administrative issues and coordinating benefits
State Contracting with Medicare Advantage Dual-Eligible Special Needs Plans: Issues and Options includes in-depth information on state approaches to D-SNP contracting
Tips to Improve Integration Using D-SNPs: Promoting Aligned Enrollment outlines benefits and considerations for states that have aligned plans
Other CHCS resources
Strengthening Medicaid Long-Term Services and Supports in an Evolving Policy Environment: A Toolkit for States provides a targeted menu of state LTSS reform strategies, including integrating LTSS with Medicare (CHCS and Manatt Health)
Advancing Medicare and Medicaid Integration: Key Program Features and Factors Driving State Investment identifies key features of effective integrated care programs

5. Visit CHCS.org to…
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Learn about cutting-edge efforts to improve care for Medicaid’s highest- need, highest-cost beneficiaries
Contact Information
Michelle Soper, Director of Integrated Care