About Us

Resource for Integrated Care (RIC) works with providers, health plans, advocates, and other subject matter experts to identify and disseminate promising practices and actionable tools to integrate and coordinate care for beneficiaries dually eligible for Medicare and Medicaid. Integrating and coordinating care is particularly important for dually eligible beneficiaries because they are more likely than others to have chronic physical and behavioral health conditions. As a result, many have extensive or complex medical or long-term care requirements, which accounts for their disproportionate contribution to Medicare and Medicaid spending.[1]

This website, Resources for Integrated Care, houses technical assistance products and webinars to assist providers and health plans in integrating and coordinating care for dually eligible beneficiaries. All RIC products are based on technical assistance needs identified through partnerships with providers, health plans, and advocates that work directly with dually eligible beneficiaries. Many of our recorded webinars are approved for enduring continuing education (CE) credits and you can access these webinars through the Continuing Education Activities page on the RIC website, through our channel on YouTube, or as podcasts segments on SoundCloud and iTunes. We encourage you to email us at RIC@lewin.com or complete a survey if you have any questions, suggested topics, feedback on any of our resources, or would like to join our listserv. You can also follow us on Twitter, @Integrate Care to learn about new products and webinars as they become available.

We invite you to explore the topic areas below to learn more about what RIC has to offer.

Behavioral Health: Forty-one percent of dually eligible beneficiaries have at least one mental health diagnosis.[2] To support providers and health plans in meeting the needs of individuals with mental health needs and substance use disorder, RIC resources and tools highlight successful care models. Key concepts include physical and behavioral health integration, supporting transitions between care settings, navigation services to link beneficiaries to essential health and community services, and empowering clients to take a more active approach to their health care needs through self-management. We offer two webinar series focused on self-management support (SMS) and navigation services. The 2017 SMS Webinar Series helps behavioral health professionals provide SMS for clients with serious mental illness or substance use disorders. The 2017 Navigation Webinar Series reviews the importance of navigation services and explores best practices for integrating navigation services within healthcare organizations. RIC also features organizational self-assessment tools to help organizations assess their capacity for delivering integrated care, SMS, and navigation services.

Disability-Competent Care (DCC): Approximately 13% of dually eligible beneficiaries have a health condition associated with a physical disability.[3] Individuals with physical disabilities and chronic conditions receive fewer preventive services and are at higher risk for poor health outcomes than individuals without physical disabilities who have the same chronic conditions.[4] In collaboration with providers, health plans, and subject matter experts, RIC developed DCC resources to help address these disparities by supporting and empowering individuals with disabilities to achieve maximum function and better health outcomes. The DCC Self-paced Training Assessment Review Tool (DCC-START) and the Disability-Competent Care Self-Assessment Tool (DCCAT) are aids for organizations seeking to identify strategic opportunities for improvement in providing DCC. The 2018 DCC Webinar Series explores key concepts of the DCC model and how organizations can best implement these concepts to empower providers and dually eligible beneficiaries with disabilities to best meet their care needs.  

Geriatric-Competent Care (GCC): Approximately 60% of dually eligible individuals are over the age of 65.[5] Individualized person-centered planning and collaborative partnerships improve the quality and accessibility of care for older dually eligible beneficiaries.[6] RIC features resources to help health plan leaders, primary care physicians, nurse practitioners, social workers, caregivers, and organizations implement best practices in meeting the needs of older adults through interdisciplinary care teams, dementia care, diagnosis and treatment of Parkinson’s disease, and supporting family caregiving. The 2018 GCC Webinar Series includes training on substance use disorders, safe and effective medication use in older adults, addressing the behavioral health needs of older adults, and person-centered approaches to support dually eligible individuals.

Member Engagement: RIC offers tools for health plans, providers, and frontline community partners to bring members’ voices and perspectives into plan or practice governance and encourage members to play an active role in managing their health and participating in health care decisions. We feature webinars highlighting best practices in engaging hard-to-reach populations, building a person-centered culture of care, and fostering organizational buy-in to make member engagement a top priority. We are also developing issue briefs on how community health workers can be engaged to meet the needs of dually eligible beneficiaries, a resource on motivational interviewing for increasing member engagement, a webinar featuring innovations in member engagement for rural populations, and a webinar series on meaningful member engagement.

Cultural Competence: The dually eligible population is more racially and ethnically diverse than the Medicare-only population. In 2016, 37.3% of dually eligible beneficiaries were of a racial or ethnic minority group compared to 13.8% of Medicare-only beneficiaries.[7] Dually eligible beneficiaries from minority racial or ethnic populations are at higher risk for poor health outcomes and lower quality of care when compared to other Medicare beneficiaries.[8] Culturally competent care has the potential to address these disparities and improve the health outcomes and care experiences of diverse populations. Culturally competent and linguistically appropriate services are respectful of and responsive to the health beliefs, practices, and needs of diverse individuals. To support providers and health plans serving a diverse population of dually eligible beneficiaries, we have compiled a variety of general cultural competence resources featuring toolkits, data collection best practices, and promising practices. We also feature a webinars on cultural competence in long-term services and supports (LTSS) and on identifying and meeting the language preferences of health plan members. To support direct care workers and the organizations that employ them, we will develop a series of briefs on how they can incorporate cultural competence. We are also developing a resource compendium on cultural competence in long-term care for LGBT beneficiaries and one on long-term services and supports.

Intellectual and Developmental Disabilities (I/DD): Approximately 8% of individuals dually eligible for Medicare and Medicaid under the age of 65 have an intellectual disability or related condition.[9] Increasingly, providers and health plans are supporting people with I/DD in achieving their individual health and independence goals using personalized approaches in a managed long-term services and supports (MLTSS) environment. RIC features resources that support providers and health plans to collaborate more effectively, resolve key issues, and improve coordination of services and supports to people with I/DD. The My Health, My Life Toolkit includes person-centered planning tools for improving transitions between care settings and communication with providers.

Long-Term Services and Supports: We partnered with provider associations to identify challenges in working in a managed care environment and best practices in dealing with these challenges. Based on this collaboration, we developed multiple briefs on key considerations for health plans and providers as they work with dually eligible beneficiaries. The briefs cover topics such as training and credentialing (resources for direct service workers and employers), contracting with health plans (key considerations for behavioral health and LTSS providers), and identifying and engaging LTSS providers (considerations for health plans).

The Medicare-Medicaid Coordination Office (MMCO) in the Centers for Medicare & Medicaid Services (CMS) is dedicated to helping beneficiaries dually eligible for Medicare and Medicaid have access to seamless, high-quality, and cost-effective health care that includes the full range of covered services in both programs. To support providers in delivering more integrated, coordinated care to dually eligible beneficiaries, MMCO contracted with The Lewin Group to develop and disseminate technical assistance and actionable tools based on successful innovations and care models.

References:

[1] Centers for Medicare & Medicaid Services. (2018). Medicare-Medicaid Coordination Office Fact Sheet – February 2018. People Enrolled in Medicare and Medicaid. Retrieved from: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/MMCO_Factsheet.pdf

[2] Centers for Medicare & Medicaid Services. (2014). Physical and Mental Health Condition Prevalence and Comorbidity among Fee-For-Service Medicare-Medicaid Enrollees. Retrieved from: http://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-MedicaidCoordination/Medicare-Medicaid-Coordination-Office/Downloads/Dual_Condition_Prevalence_Comorbidity_2014.pdf

[3] CMS Medicare-Medicaid Coordination Office. (2012). Medicare-Medicaid Enrollee Information National, 2012. Retrieved from: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/NationalProfile_2012.pdf

[4] Reichard, A., Stolzle, H., Fox, M.H. (2011). Health disparities among adults with physical disabilities or cognitive limitations compared to individuals with no disabilities in the United States. Disability and Health Journal, 4(2):59-67.

[5] CMS Medicare-Medicaid Coordination Office. (2016). Data Analysis Brief: Medicare-Medicaid Dual Enrollment from 2006 through 2015. Retrieved from: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/DataStatisticalResources/Downloads/Eleven-YearEver-EnrolledTrendsReport_2006-2016.pdf

[6] Office of the Assistant Secretary for Planning and Evaluation. (2016). Report to Congress: Social Risk Factors and Performance under Medicare’s Value Based Purchasing Programs. Pages 61-65.

[7] CMS Medicare-Medicaid Coordination Office. (2016). Data Analysis Brief: Medicare-Medicaid Dual Enrollment from 2006 through 2015. Retrieved from: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/DataStatisticalResources/Downloads/Eleven-YearEver-EnrolledTrendsReport_2006-2016.pdf

[8] Ibid.

[9] Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission. (2018). Data Book. Beneficiaries Dually Eligible for Medicare and Medicaid. Retrieved from: http://medpac.gov/docs/default-source/data-book/jan18_medpac_macpac_dualsdatabook_sec.pdf?sfvrsn=0.