Integrated Care for People with Medicare and Medicaid: A Roadmap for Quality


In this paper, the National Committee for Quality Assurance (NCQA) discusses prior integration efforts; introduces a model for integrated entities and a framework for assessing and promoting quality of integrated care; and explores the challenges to implementing and achieving the goals of person-centered, integrated care for Medicare-Medicaid beneficiaries. They use the word “framework” to describe the key concepts underlying the structure and process measures; it can also be expanded to include the content of performance measures as companions to the structure and process measures.

Date Updated: 03/15/2013

The lack of coordination between Medicare and Medicaid for people who have coverage in both programs is well-documented, and these individuals incur high levels of spending in both programs. Because of the complexities of different coverage and program administration requirements, states have found it challenging to work with plans and providers to create programs that provide the full range of services that people with Medicare and Medicaid need…

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