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Data Integration, D-SNP Provisions, plus Upcoming Calls & Webinars

Recent Releases and Announcements

Medicare-Medicaid Data Integration/ State Data Resource Center Announcement

The Medicare-Medicaid Data Integration (MMDI) contractor has released two new opioid use cases that are available on the State Data Resource Center (SDRC) website. MMDI helps demonstration states (MMCO’s Financial Alignment Initiative and CMCS’ Innovation Accelerator Program) with in depth, state-centered technical assistance. This includes tools to successfully understand and analyze Medicare data as well as integrating those data with Medicaid and other data on the state’s IT platform.

The first use case is “Profiling the Provider Role in Opioid Prescribing among Dual Eligible Beneficiaries – Full Use Case” and is now available through the State Data Resource Center  website. Research shows that excessive and inappropriate prescribing of opioids is a widespread problem among providers and is largely responsible for the observed trends in opioid misuse. This use case will provide guidance to assist state Medicaid Agencies (SMAs) on how to leverage Medicare Part D Prescription Drug (PDE) data, along with other publically available data sources to profile providers who prescribe opioids to dual eligible beneficiaries. This will enhance SMAs' abilities to identify opportunities to implement programs and policies that result in safer prescribing of opioids.

The second use case is “Profiling Potential Opioid Misuse among Dual Eligible Beneficiaries – Full Use Case.” It is also available through the State Data Resource Center  website.

Prescription opioid misuse has emerged as a growing epidemic. To address prescription opioid misuse among dual eligible beneficiaries, state Medicaid Agencies (SMAs) must understand prescription filling patterns and factors associated with opioid misuse within this population. This use case shows SMAs how to use Medicare Part D Prescription Drug Event (PDE) data, with other Medicare and Medicaid data sources, to examine opioid prescription fills among dual eligible beneficiaries and identify potential misuse. 

The SDRC assists states with the data request process and documents, facilitates state peer-to-peer learning and information exchange, and educates and trains state personnel on use of the Medicare data.  For more information, please contact SDRC via the support line, (877) 657-9889 or email sdrc@econometricainc.com.

Provide input on D-SNP provisions of the Bipartisan Budget Act of 2018

We want your input!

Section 50311(b) of the Bipartisan Budget Act of 2018 (Public Law No. 115-123)[1] creates a new Section 1859(f)(8) of the Social Security Act in order to increase integration of Dual Eligible Special Needs Plans (D-SNPs). In particular, the statute directs CMS to: 1) develop unified grievance and appeals processes for D-SNPs; and 2) establish new standards for integration of Medicare and Medicaid benefits for D-SNPs. We are soliciting comments to help inform our next steps related to unified D-SNP grievance and appeals processes and new integration standards.

Through April 12, 2018, CMS is inviting written stakeholder input on these provisions. Please see the request for stakeholder input . Please submit comments, with the subject line “Comments on Section 50311,” to MMCOCapsmodel@cms.hhs.gov.

Medicaid Innovation Accelerator Program

Register Now: Medicaid IAP National Learning Webinar (March 26, 2018)
Addressing Administrative and Regulatory Barriers to Physical and Mental Health Integration

CMS’s Medicaid Innovation Accelerator Program (IAP) Physical and Mental Health Integration program area is hosting a national learning webinar on Monday, March 26, 2018 from 1:30 - 3:00 pm ET about addressing administrative and regulatory barriers to physical and mental health integration.

The webinar will feature speakers from two state Medicaid agencies, Arizona and New York, who will share how they are developing and improving current administrative and reimbursement strategies that promote integration. Speakers include Tom Betlach, Medicaid Director, Arizona Health Care Cost Containment System; Keith McCarthy, Director, Bureau of Inspection and Certification, New York State Office of Mental Health; Trisha Shell-Guy, Deputy Counsel, New York State Office of Alcoholism & Substance Abuse Services; and Shaymaa Mousa, MD, MPH, Empire State Fellow, Office of Primary Care and Health Systems Management, New York State Department of Health.

Participants will also learn about key policy, financial, and operational building blocks for integration at the state level. The strategies presented on this webinar will be applicable to a variety of states interested in planning and implementing a physical and mental health integration approach, and working to better align administrative functions to support these efforts.

Register Now 

Value-Based Payment and Financial Simulations New Technical Support Opportunity for States
Expression of Interest Form Due April 13, 2018

The Medicaid Innovation Accelerator Program’s Value-Based Payment (VBP) and Financial Simulation functional area is launching an 12-month technical support opportunity for up to 10 states seeking to design, develop, and implement Value-Based Payment approaches (i.e. payment models that range from rewarding for performance in Fee-for-Service to capitation, including alternative payment models and comprehensive population-based payments).

Selected states will have the opportunity to work with VBP and financial simulation experts through individualized technical support and state-to-state learning activities. This technical support opportunity is open to states at all levels of experience and progress in developing a VBP approach. 

Review the Program Overview (PDF, 146.07 KB) (PDF 146.07 KB) and Information Session Slides (PDF, 146.07 KB) (PDF 146.07 KB). Interested states are asked to complete and email the Expression of Interest (DOCX, 67.03 KB) (MS Word 67.03 KB) by April 13, 2018.

Upcoming Calls and Webinars

2018 Disability Competent Care Webinar Series

Time/Date: Weekly on Wednesdays from 2-3pm ET, March 14, 2018- April 4, 2018

This series is intended to aid providers and health care professionals in improving the delivery of care to persons with disabilities.  Individuals with disabilities enrolled in both Medicare and Medicaid are at higher risk for poor health outcomes when compared to individuals without disabilities.1  This seven-part series will explore key concepts of the Disability-Competent Care (DCC) model and how organizations can best implement these concepts to empower providers and participants with disabilities to best meet their care needs.

Interdisciplinary Team Building, Management, and Communication, March 21, 2018

This webinar will explore the value of the interdisciplinary team (IDT) in supporting and empowering participants with disabilities. Presenters will provide concrete and innovative strategies to improve the management and communication within the IDT, including meeting execution, agenda setting, and facilitating communication when in-person meetings are not practical. Refining or designing new IDT processes/procedures is a crucial step to improving the participant experience and promoting participant-centered care.

Managing Transitions with Adults with Disabilities, March 28, 2018

This webinar will describe the challenges participants with disabilities experience as they face care settings transitions and steps that providers can take to help empower participants to make informed decisions and improve care outcomes during these transitions. The presentation will help health plans and health systems prepare for successful transitions using innovative approaches to improve the participant experience, increase the quality of care, and build relationships with local and community-based care settings.

Building Partnerships: Health Plans and Community-based Organizations, April 4, 2018

This webinar will explore the benefits of partnerships between health plans and community-based organizations to establish a network with local leadership and support community integration for persons with disabilities. This webinar will highlight how one Center for Independent Living has created such a partnership program in Southern Colorado, with services to engage participants and improve their integration in the local community.

Register Now 

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