Dual Eligible Special Needs Plans (D-SNPs) are a type of Medicare Advantage plan that serve beneficiaries dually enrolled in Medicare and Medicaid. To operate in a state, D-SNPs must have a contract with the state to facilitate coordination of Medicare and Medicaid services for enrollees,...

States seeking to better integrate care for Medicare-Medicaid enrollees need to understand Medicare benefits and enrollee cost-sharing provisions in order to better structure and coordinate the Medicaid beenfits they will be offering to these enrollees. This technical assistance brief provides...

This chartbook presents highlights and key comparisons from the statistical compendium on Medicaid pharmacy benefit use and reimbursement in 2009 that Mathematica prepared for CMS. Mathematica has prepared similar compendiums and chartbooks for 1999 and for each year from 2001 to 2009. The 2009...

Improving the ability of the long-term care system to meet the needs of an aging population is at the top of the nation’s policy agenda. This issue brief describes the demographic characteristics of vulnerable adults—those at significant risk of needing long-term care services in...

This technical assistance brief explores ways of improving the coordination of these overlapping benefits in the Centers for Medicare & Medicaid Services (CMS) Financial Alignment Initiative’s capitated model demonstrations.

Oklahoma’s Medicaid managed care 1115 waiver program, SoonerCare, has been through many changes in the last 15 years, including the end of fully capitated managed care in 2003 and expansion statewide of the SoonerCare Choice enhanced primary care case management program....