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In addition, states have several program design options that can increase the degree of Medicare-Medicaid integration and alignment in their DSNP-based programs, including from least to most aligned (Archibald & Kruse, 2015): Include Medicare Cost-Sharing, Medicaid Wraparound Services, or Both : States can require DSNPs to pay enrollees' Medicare premiums and cost-sharing out of their capitation payments (state Medicaid agencies would otherwise pay for premiums or cost-sharing directly), which can help to coordinate claims processing, reduce administrative burden on providers, and decrease instances of balance billing of enrollees

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Quality vendor comparisons guide sourcing decisions

doi:10.1016/j.cld.2013.07.002 [PMC Full Text] [PubMed] [Crosslink] 61