Resources

Official State and Federal Resources on MI Health Link and Integrated Care

The Michigan Department of Health and Human Services (MDHHS) has resources and a toolkit regarding Mi Health Link.

  • This webpage is MDHHS’ main page on MI Health Link, the new integrated care program. It has a brief overview of the program, information about the public forums where the program will be discussed, and links to documents and more information.
  • The Resources/Toolkit  has guides to enrollment, copies of letters sent to beneficiaries, contacts, and many other links and documents designed to answer frequently asked questions.

Centers for Medicare & Medicaid Services

MI Health Link Macomb County Implementation Forum
Michigan Department of Health and Human Services (MDHHS)
June 4, 2014

  • This is the PowerPoint presentation given by MDHHS at the public Forum in Macomb County in June 2014. It includes information about what MI Health Link is, who is eligible for it, what kinds of health care it will cover, the enrollment process, how people’s health care will be coordinated, the Advisory Committee, and more.

MI Health Link Kalamazoo Implementation Forum [Questions and Answers]
Michigan Department of Health and Human Services (MDHHS)
April 8, 2014

  • These “Questions and Answers” provide more detailed, specific information about MI Health Link. Among the many questions and answers is information about eligibility, requirements that the Integrated Care Organizations (health plans) have to meet, ICO’s networks of providers, the role of the Michigan Medicare/Medicaid Assistance Program (MMAP) in helping consumers understand the program and their options, the interaction between ICOs and PIHPs (Prepaid In-patient Health Plans that provide mental health care), the Integrated Care Bridge Record (ICBR—the electronic medical records that will be used for beneficiaries), and more.

 Memorandum of Understanding (MOU) Between The Centers for Medicare & Medicaid Services (CMS) And The Michigan Department of Community Health Regarding a Federal-State Partnership to Test a Capitated Financial Alignment Model for Medicare-Medicaid Enrollees.

  • This long, detailed document is the agreement between the federal government and the State of Michigan to establish MI Health Link. Among the many kinds of information included is information about:

o   How MI Health Link will work generally

o   Enrollment

o   Protections for enrollees and opportunities for involvement

o   How people enrolled in MI Health Link can appeal or file grievances

o   Quality management

o  Financing and payment for MI Health Link

o   Evaluating how MI Health Link is working

o   Changing or terminating MI Health Link

o   Definitions of key terms

o   Payments to ICOs

o   Care coordination

o   Provider networks

o  Benefits that will be covered

o  ICO marketing, outreach, and education activity

o   Administration and oversight

o   Quality measures under MI Health Link

Financial Alignment Capitated Readiness Review: Michigan Readiness Review Tool
Centers for Medicare & Medicaid Services and the Michigan Department of Community Health

  • The state of Michigan used this document to determine whether ICOs were ready to start serving as MI Health Link health plans. The first page of this document explains the readiness review tool and the areas it covers.

Michigan’s Proposal: Integrated Care for People who are Medicare-Medicaid Eligible
Michigan Department of Community Health
April 26, 2012

  • This is the detailed proposal for Michigan’s integrated care demonstration project that the Michigan Department of Community Health submitted to the federal Centers for Medicare & Medicaid Services for review. The first page of the document includes an introduction to the proposal, including an explanation of what happened before the proposal and what would happen after it.

Official State Resources on How Consumers Can Help Shape MI Health Link

Integrated Care Demonstration – Stakeholder Participation Opportunities
Michigan Department of Health and Human Services (MDHHS)

  • Go to this webpage for details about the upcoming public forums (called an “Implementation Forum”) as well as documents from and about the public forums that have already been held.  These forums are rotated around the four demonstration project areas.

MI Health Link Advisory Committee
Michigan Department of Health and Human Services (MDHHS)

  • This webpage provides information about the MI Health Link Advisory Committee and how to apply for it. The Advisory Committee will provide MDHHS with input on MI Health Link and help with certain parts of the program. The Committee will mostly be made up of people eligible for MI Health Link and their families and advocates.

MI Health Link Advisory Committee: Frequently Asked Questions (FAQs)
Michigan Department of Health and Human Services (MDHHS)

  • These FAQs include information about what the Advisory Committee is, what it does, who will be on it, how often it will meet, how to apply, how people will be selected for it, and more.

Other Resources and Background about MI Health Link

Michigan Memorandum of Understanding: What Advocates Need to Know
Community Catalyst
April 2014

  • This fact sheet about MI Health Link includes information about the program’s enrollment, long-term supports and services, care coordination, benefits and provider networks, opportunities for involvement by consumers, financing and payment, and cultural competency and Americans with Disabilities Act compliance, as well as a list of key issues to watch.

Michigan Becomes the Ninth State to Move Forward with Capitated Duals Demonstration
Community Catalyst
April 30, 2014

  • This blog post provides a brief overview of MI Health Link and discusses examples of how MI Health Link is structured in the best interests of consumers as well as areas of concern for consumers.

Michigan Voices for Better Health: A Consumer Perspective on Integrated Care for People Eligible for Medicaid and Medicare
Michigan Elder Justice Initiative and Michigan Disability Rights Coalition
June 4, 2014

  • This is the PowerPoint presentation given by the Michigan Elder Justice Initiative and the Michigan Disability Rights Coalition at the public Implementation Forum in June 2014. It includes the story of a consumer, how the current health system didn’t work for her, and how MI Health Link might be able to improve her experience. It also includes suggestions for consumers about what to do to get the most out of MI Health Link as well as information about how consumers can help shape the MI Health Link program.

Patient-Centered Care and Person-Centered Planning: What’s the Difference?
Michigan Disability Rights Coalition
June 4, 2014

  • This is the PowerPoint presentation that the Michigan Disability Rights Coalition gave at the public Implementation Forum in June 2014. It includes information about patient-centered care and person-centered planning and how these two principles are both similar and different. Person-centered planning plays a big part in MI Health Link.

Resources on Integrated Care and Demonstrations Generally

Financial Alignment Initiative
Centers for Medicare & Medicaid Services

  • This webpage is a general page from the federal government about integrated care demonstration programs. It includes a list of recent developments in demonstrations around the country, an overview of integrated care demonstrations, many links to more specific and detailed information, and more.

How will Voices for Better Health Improve Care for Dual Eligibles? [a video]
Community Catalyst

  • This webpage includes a short video (on the right-hand side toward the bottom of the page) that provides an easy-to-understand introduction to integrated care and the need for it. It explains who dual eligibles are and some of their characteristics, describes the problems that dual eligibles have faced with Medicare and Medicaid as separate systems, and discusses dual eligible demonstrations, integrated care, and the importance of consumer involvement.

Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries
The Henry J. Kaiser Family Foundation
October 2012

  • This policy paper answers some general questions about integrated care demonstrations. These questions address and provide information about who dual eligibles are, the two basic financial options for these demonstrations, the types of care coordination that will be involved, how the demonstrations will affect financing of Medicare and Medicaid services, and more.

Improving Care for Medicare-Medicaid Beneficiaries
Voices for Better Health / Community Catalyst
June 4, 2014

  • This is the PowerPoint presentation given by Voices for Better Health / Community Catalyst at the public Implementation Forum in June 2014. It includes information about the Medicare-Medicaid Coordination Office, integrated care demonstrations generally and around the country, the importance of engaging consumers in integrated care demonstrations, and different ways that these demonstrations can involve consumers.

Resources on Specific Aspects of Integrated Care Demonstrations

Financial Alignment Demonstration Capitated Model Medicare Rate Methodology
Integrated Care Resource Center
November 1, 2013

  • This PowerPoint presentation includes fairly detailed information about how Medicare rates are set for the capitated financial option in integrated care demonstrations.

Extended Study Hall Call Series: Three Way Contract
Integrated Care Resource Center
May 30, 2013

  • This PowerPoint presentation provides basic information about the three way contract that is signed by the federal government, the state, and the health plans in integrated care demonstration programs, including an overview of the contract, its structure and organization, financing, general terms and conditions, the relationship between the contract and other documents, and more.

Three-Way Contracting – The Massachusetts Experience
Integrated Care Resource Center
October 31, 2013
[Powerpoint]

  • This PowerPoint presentation by Massachusetts and the Centers for Medicare and Medicaid about their experiences writing the three-way contract for Massachusetts’ integrated care demonstration. The speakers talk about successes and challenges and offer considerations and suggestions for other states engaging in three-way contracting for their integrated care demonstrations.

Study Hall Call: Integrated Marketing Materials
Medicare-Medicaid Coordination Office
July 11, 2013

  • This PowerPoint presentation is about marketing integrated care demonstration programs. It includes information about marketing principles, what is and is not considered marketing, major areas of focus in state-specific marketing guidance, marketing materials for people enrolled in demonstration programs, reviews of marketing materials, information and examples from Massachusetts, and more.

You’ve Got Mail: Designing Enrollment Notices for a Dual Eligible Demonstration Rollout
National Senior Citizens Law Center
June 2014

  • This paper discusses the process of designing and the content of notices about enrollment to be sent to people who are eligible for and/or will be enrolled in integrated care demonstrations. It gives examples from five states (Massachusetts, Ohio, Illinois, California, and Virginia) to show what has worked and where there have been challenges.

Measurement, Monitoring and Evaluation of State Demonstrations to Integrated Care for Medicare-Medicaid Enrollees
RTI International
March 14, 2013

  • This PowerPoint presentation provides information about how states’ integrated care demonstration programs will be assessed after they go into effect.

Resources on Consumer and Stakeholder Involvement and Outreach In Integrated Care Demonstrations Generally

Meaningful Consumer Engagement: A Toolkit for Plans, Provider Groups and Communities
Community Catalyst

  • This webpage introduces a toolkit on consumer engagement in integrated care demonstrations, with links to four primary tools which have information and suggestions about:

o   Consumer Advisory Committees

o  Member Meetings

o   Recruitment for Consumer Engagement

o   Checklist for Diversity, Incentives & Barriers

Consumer Outreach in the Dual Eligible Demonstrations
National Senior Citizens Law Center
April 8, 2014
[audio + Powerpoint]

  • This PowerPoint presentation and audio recording provide suggestions for how to reach out to, educate, and communicate with consumers. Among the topics covered are notices about enrollment to consumers, tools that can be used to reach out to and communicate with consumers, and how outreach, education, and communication should be conducted.

Talking to Your Clients about the Duals Demonstration and MLTSS: Keeping it Simple
National Senior Citizens Law Center
September 30, 2013
[audio + Powerpoint]
[Powerpoint only]

  • This PowerPoint presentation and audio recording provide information about managed long-term services and supports generally as well as their relationship with integrated care demonstrations. These resources have easy-to-understand messages for consumers and additional background information for advocates about integrated care demonstrations as well as about other managed care.

Dual Eligible Demonstration Projects: Top Ten Priorities for Consumer Advocates
Community Catalyst
March 2012

  • This paper provides background on dual eligibles and integrated care and discusses the top ten priorities for advocates for shaping states’ integrated care demonstrations.

Greater Than the Sum: Using Integrated Care to Reduce Racial and Ethnic Health Disparities Among Dual Eligibles: Role for Consumer Advocates
Community Catalyst
April 2013

  • This short paper lists ways that advocates can get involved in dual eligible demonstrations, focusing on the goal of reducing racial and ethnic disparities.

Background Information and Data Relevant to Integrated Care Demonstrations Generally and in Michigan

Medicare Basics: An Overview for States Seeking to Integrate Care for Medicare-Medicaid Enrollees
Integrated Care Resource Center / Mathematica Policy Research
July 2013

  • This paper provides an overview of Medicare and how it interacts with Medicaid, covering issues like Medicare eligibility, services covered by Medicare and Medicaid, how and when people choose their Medicare coverage, how rates are set for Medicare services, and more.

Medicare 101 and 201: Key Issues for State Programs for Medicare-Medicaid Enrollees
Integrated Care Resource Center
March 13, 2014
[Powerpoint]

  • This PowerPoint presentation provides some information and data about Medicare and Medicaid issues that are relevant for integrated care demonstrations, including issues involving eligibility, coverage, spending, managed care options, Special Needs Plans (SNPs), coordination of care, and more.

The Diversity of Dual Eligible Beneficiaries: An Examination of Services and Spending for People Eligible for Both Medicaid and Medicare
The Henry J. Kaiser Family Foundation
April 2012

  • This paper provides data and information about dual eligibles, including data and information related to demographics, how dual eligibles and their health care services and costs are different from other Medicare beneficiaries, Medicaid versus Medicare spending on dual eligibles, and high-cost dual eligibles.

Medicare-Medicaid Enrollee State Profile: Michigan – 2008
Centers for Medicare & Medicaid Services

  • This document has data and information from 2008 about dual eligibles in Michigan. Among the data and information included is the number of dual eligibles, their demographic characteristics, the physical, mental health, and disability related conditions of certain dual eligibles, the rates at which certain dual eligibles used services, the average amount of money spent for certain categories of dual eligibles, and more.

Resources on Dual Eligibles’ Experiences and Preferences

Experiences of Medicare-Medicaid Enrollees: Findings From Focus Groups in Five States
Thomson Reuters Healthcare
December 2011

  • This paper provides background on and the findings resulting from 21 focus groups made up of dual eligibles sponsored by the Medicare-Medicaid Coordination Office. The findings include what dual eligibles know about Medicare and Medicaid, how they make enrollment decisions, how they experience services and benefits, what language they use, and what they would change about their care.

Experienced Voices: What Do Dual Eligibles Want From Their Care? Insights from Focus Groups with Older Adults Enrolled in Both Medicare and Medicaid
Lake Research Partners and AARP Public Policy Institute
December 2011

  • This paper provides background on and the findings resulting from 10 focus groups made up of dual eligibles sponsored by the AARP Public Policy Institute. The paper reports the findings by focus group, identifies general themes from all the focus groups, and lists issues for further exploration and research. The general themes cover issues such as care satisfaction, fee-for-service versus integrated programs, provider choice, billing, access to services, care coordination, appeals processes, provider communication, and care experience concerns.

Integrating Care for Dual Eligibles: What Do Consumers Want?
Alliance for Health Reform and AARP Public Policy Institute
December 2011
[event summary]

  • This event summary is from a briefing about dual eligibles and integrated care, focusing on the viewpoints of dual eligibles and other stakeholders. The speakers talk about the findings and themes resulting from focus groups made up of dual eligibles sponsored by the Medicare-Medicaid Coordination Office and the AARP Public Policy Institute, Massachusetts’ integrated care project, and stakeholder engagement.

Commentary on Integrated Care Demonstrations Generally

Risky Business: Capitated Financing in the Dual Eligible Demonstration Projects
Community Catalyst
March 2013

  • This paper comments on the capitation financial option for integrated care demonstrations. It argues for a cautious approach to capitation, explains how certain states’ capitation demonstrations are worrisome, and offers recommendations for contracts with health plans to improve the capitation system.

The Dual Eligible Demonstration Projects: The Passive Enrollment Challenge
Community Catalyst
January 2013

  • This paper provides select background on the dual eligible population, explains the reason that passive enrollment is being used, discusses challenges and problems that have happened with passive enrollment, proposes an alternative to passive enrollment, and offers recommendations for changes to decrease concerns about passive enrollment.

The Dual Eligible Demonstration Projects: State and Health Plan Readiness
Community Catalyst
January 2013

  • This paper lays out concerns about how ready states and health plans are to start the integrated care demonstrations and offers a number of recommendations related to state and health plan readiness.

Is It Working? Recommendations for Measuring Rebalancing in Dual Eligible Demonstrations and MLTSS Waivers
National Senior Citizens Law Center
January 2014

  • This paper discusses and offers recommendations about how to measure efforts to “rebalance” Medicaid long term care services to promote more home and community based care and services and reduce the use of nursing facilities. This is relevant to integrated care because integrated care demonstrations have to support this “rebalancing.” The paper also includes a chart that has some examples of rebalancing measures in dual eligible demonstrations.