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Integrated Care Initiatives

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Advancing Delivery and Payment Reform in Managed Care Provider Networks: Tools for Purchasers

CHCS developed the following set of resources to help state purchasers design and implement effective VBP strategies within managed care. The resources, which draw from interviews and past work with state and federal VBP experts across the country.



Designing Appeals Procedures the Dual-Eligible Demonstrations

The core concept in the dual eligible financial alignment demonstration is integration � integration of payment streams, integration of services and, importantly, integration of appeals processes so that beneficiaries will have a system that protects both Medicare and Medicaid rights, ensures due process, and is easy to understand and navigate.



Ensuring Consumers' Access to Care

Network adequacy state insurance survey findings and recommendations for regulatory reforms in a changing insurance market



Issue Brief: Key Themes in Capitated Medicaid Managed Long-term Services and Supports Waivers

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This issue brief examines key themes in 19 capitated Medicaid MLTSS waivers approved to date by the Centers for Medicare and Medicaid Services (CMS), including 1115 demonstrations in 12 states (AZ, CA, DE, HI, KS, NJ, MN, NY, RI, TN, TX, VT) and 1915(b)/(c) waivers in six states (FL, IL, MI (2 waivers), MN, OH, WI). MLTSS programs provided under these authorities are the subject of CMSs 2013 best practices guidance to states.



For Autistic Adults, Coverage Options Are Scarce

It is getting easier for parents of young children with autism to get insurers to cover a pricey treatment called applied behavioral analysis. Once kids turn 21, however, it is a different ballgame entirely.



Presentation: Managed Long-Term Services and Supports

Landscape from Readiness Review to Ongoing Oversight

A presentation on how lessons from managed long-term services and supports program implementation can be applied by states pursuing Medicare-Medicaid integration



Quality Measurement Approaches of State Medicaid Accountable Care Organization Programs

A technical assistance tool published by The Center for Health Care Strategies (CHCS). The tool outlines the quality measurement approaches of six states CHCS� Medicaid ACO Learning Collaborative (Colorado, Maine, Minnesota, New Jersey, Oregon, and Vermont) to inform states developing ACO programs.



Virginia's Proposed Medicaid 1115 Waiver

Center for Health Care Strategies calls it a "Step Forward for People with Mental Illness"

Virginia Governor Terry McAuliffe has announced that Virginia's Medicaid agency will initiate an 1115 demonstration wavier request to create a benefit package for people with serious mental illness to have access to both behavioral and primary health services.



Engaging Medicare-Medicaid Enrollees: Insights from Three Financial Alignment Demonstration States

States are enrolling Medicare-Medicaid enrollees in financial alignment demonstrations sponsored by the Centers for Medicare & Medicaid Services. Since dual eligible individuals can opt out of the demonstrations, state policymakers are eager to engage individuals and retain them once enrolled. Doing so will ensure that dually eligible individuals have access to high-quality, integrated services. This webinar explored the lessons learned by three states that have implemented capitated integration models: Massachusetts, Ohio, and Virginia.



Descriptive Study of Three Disability Competent Managed Care Plans for Medicaid Enrollees

This report describes the organizational features of three disability competent health systems: Commonwealth Care Alliance in Massachusetts; Community Health Partnership) in Wisconsin; and Independence Care System in New York City. These programs integrate health and social services to deliver patient-centered care to Medicaid and Medicare beneficiaries with particularly complex chronic care needs. To provide program operators with useful information about these programs, the report details how staff deliver services and coordinate care for people with disabilities.



One Year into Duals Demo Enrollment-- Early Expectations Meet Reality

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In the latest post in the Policy Insights series from the Henry J. Kaiser Family Foundation, a new blog post highlights key challenges and trends emerging in states� demonstrations designed to better coordinate financing and health care services for millions of seniors and non-elderly people with significant disabilities who are dually eligible for both Medicaid and Medicare.



Global Payments: A Key Step toward Totally Accountable Care

A blog post from the Center for Health Care Strategies, Inc. arguing in support of global payment models for health care.



Navigating the Health Insurance Landscape-What is Next for Navigators, InPerson Assisters and Brokers

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What has been the effect of navigator and other in-person assistance programs? Has the role of brokers changed? What are some of the key policy and financing questions for in-person assistance programs looking forward? Are the privacy concerns of citizens being addressed by proper and effective confidentiality policies? A panel of experts addressed these and related questions at an August 5, 2014, Kaiser Family Foundation and the Alliance for Health Reform briefing.



Key Attributes of High-Performing Integrated Health Plans for Medicare-Medicaid Enrollees

The Commonwealth Fund supported the creation of PRIDE (PRomoting Integrated Care for Dual Eligibles), which is bringing together leading health care organizations to identify and advance strategies for providing high-quality and cost-effective care for Medicare-Medicaid enrollees and other high-need populations.



Financial Alignment Demonstrations for Dual Eligible Beneficiaries: A Look at CMS's Evaluation Plan

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The Henry J. Kaiser Family Foundation has released a new issue brief that describes the Centers for Medicare and Medicaid Services� plan to evaluate the demonstrations, via its contract with RTI International

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