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The Centers for Medicare & Medicaid Services (CMS),
Medicare-Medicaid Coordination Office (MMCO) is pleased to share the following
updates:
- State Medicaid
Director Letter: Three New Opportunities to Test Innovative Integrated
Care Models for Individuals Dually Eligible for Medicaid and Medicare
- ICRC Webinar:
Promising Practices for Meeting the Needs of Dually Eligible Older
Adults with Substance Use Disorders
State Medicaid Director Letter: Three New Opportunities to Test
Innovative Integrated Care Models for Individuals Dually Eligible for
Medicaid and Medicare
On April 24, the Centers for Medicare & Medicaid Services (CMS) sent
a letter to State Medicaid Directors inviting states to partner with CMS to
test innovative approaches to better serve those who are dually eligible
for Medicare and Medicaid. Many of the 12 million dually eligible
beneficiaries have complex healthcare issues, including multiple chronic
conditions, and often have socioeconomic risk factors that can lead to poor
outcomes. Today’s letter opens new ways to address those complex needs,
align incentives, encourage marketplace innovation through the private
sector, lower costs, and reduce administrative burdens for dually eligible
individuals and the providers who serve them.
As one of CMS’ Strategic Priorities for 2019, we are redoubling efforts
to better serve older adults and people with disabilities dually eligible
for Medicaid and Medicare. Our goal is to bring shared accountability for
creating a more seamless experience for beneficiaries and providers across
the two programs, while ensuring that the program’s incentives are aligned
and pointed toward lower cost and better outcomes.
Approaches discussed in the State Medicaid Directors letter include:
- The Capitated
Financial Alignment Model. Through a joint contract with CMS, states and
health plans, this model option creates a way to provide the full
array of Medicare and Medicaid services for enrollees for a set
capitated dollar amount.
- Managed
Fee-for-Service Model. This model is a partnership between CMS and the
participating state and allows states to share in Medicare savings
from innovations where services are covered on a fee-for-service (FFS)
basis.
- State-Specific
Models.
CMS is open to partnering with states on testing new state-developed
models to better serve dually eligible individuals and invite states
to come to us with ideas, concept papers, and/or proposals.
Today’s letter complements a State Medicaid Director Letter CMS released in December
2018 that highlighted ten opportunities to improve care for dually
eligible individuals, including using Medicare data to inform care
coordination and program integrity initiatives, and reducing administrative
burden for dually eligible individuals and the providers who serve them.
The opportunities in today’s letter, together with the Primary Cares Initiative, present an array of options
for transforming care delivery.
SMD: Three New Opportunities to Test Innovative Integrated
Care Models for Individuals Dually Eligible for Medicaid and Medicare
ICRC Webinar: Promising Practices for Meeting the Needs of Dually
Eligible Older Adults with Substance Use Disorders
Date/Time: Thursday, May 16, 2019 - 1:30pm - 3:00pm ET
Older adults with SUD benefit from treatment approaches that are age and
generationally appropriate, and designed to address common co-occurring
conditions, mobility limitations, and social factors. Evidence has shown
that age-specific programs, such as group therapy for older adults, lead to
better long-term treatment outcomes.
This interactive webinar will discuss common SUDs among dually eligible
older adults, identify promising practices for screening, treatment, and
care coordination, and demonstrate practical strategies for meeting the
needs of older adults with SUDs. Speakers, including a consumer with lived
experience, will share lessons learned and strategies to provide effective
care for dually eligible older adults with SUDs.
Featured Speakers:
- Dr. Louis Trevisan,
MD, Associate Professor of Psychiatry, Yale University
- Dr. Nicole
MacFarland, PhD, Executive Director, Senior Hope
- Elizabeth Baumann,
LSW, Case Manager, Council of Aging of Southwestern Ohio
- Sherri, CASAC,
Consumer
To register and for CME/CE information, click here: https://www.resourcesforintegratedcare.com/Behavioral_Health/2019_BH_Webinar/Older_Adults_with_SUD
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