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

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)

Significant Growth in Integrated Care Programs for Dually Eligible Individuals LA 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

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

Visit CHCS.org to… Download practical resources to improve the quality and cost- effectiveness of Medicaid services Subscribe to CHCS e-mail, blog and social media updates to learn about new programs and resources Learn about cutting-edge efforts to improve care for Medicaid’s highest- need, highest-cost beneficiaries Contact Information Michelle Soper, Director of Integrated Care msoper@chcs.org