This issue brief explores the attributes of a potential Medicare-Medicaid integrated model focused on ensuring high quality and high value care for dual eligible long-stay nursing facility residents. We identify policy opportunities for CMS and states to consider to facilitate a Medicare-Medicaid model in nursing facilities, including increasing payment transparency, promoting alignment between Medicare and Medicaid quality measures, and requiring that a percentage of plan payment go towards value-based contracts with nursing facilities. Taken together, these model elements could meaningfully improve experiences for dual eligible individuals living in nursing facilities, and for their families.
ATI Advisory is pleased to release these first resources as part of our State Resource Center. We will continue to release state resources reflecting the latest insights and novel strategies, tip sheets, and education on the ever-changing market and federal policy environment, and what it means for states.Read More Read More
Since 2019, ATI Advisory and the Long-Term Quality Alliance, with support from The SCAN Foundation, have led national efforts to advance person-centered, non-medical supplemental benefits in Medicare Advantage.Read More Read More
After five years of growth of nonmedical supplemental benefits, there are significant gaps in our knowledge and the data around these benefits, especially from the perspectives of Medicare beneficiaries. Action must be taken to close data gaps so that policymakers have the information necessary to assess and, if needed, refine these benefits to align with their original intent to support the needs of individuals with complex chronic conditions. ATI Advisory and Long-Term Quality Alliance, with support from the SCAN Foundation, created the Evaluation Framework to chart a path for multiple stakeholders – including plans, policymakers, and researchers – to provide timely insights on Medicare Advantage enrollee needs, understanding, access, and experience of benefits; to enhance plan capabilities to collect and use data to improve benefit offerings; and to build the evidence base on nonmedical benefits’ effects.Read More Read More