Note that we are considering the following as integrated models (definitions adapted from the Integrated Care Resource Center (ICRC) here and here).
Fully integrated dual eligible special needs plans (FIDE SNPs): Dual eligible special needs plans (D-SNPs) that provide coverage of Medicare and Medicaid benefits through both: (1) a Medicare Advantage (MA) contract with CMS; and (2) a contract with the state Medicaid agency covering at least Medicaid primary and acute-care services, long-term services and supports (LTSS), and behavioral health. (For more detail see 42 CFR 422.2)
Highly integrated dual eligible special needs plans (HIDE SNPs): Dual eligible special needs plans (D-SNPs) that provide coverage of Medicare and Medicaid benefits through both 1) a Medicare Advantage (MA) contract with CMS; and (2) a contract with the state Medicaid agency covering at least Medicaid primary and acute-care services and either long-term services and supports (LTSS), or behavioral health benefits, or both. (For more detail see 42 CFR 422.2)
Program of All-Inclusive Care for the Elderly (PACE):These organizations contract with CMS and the state to provide all Medicaid and Medicare benefits.
Managed Fee-for-Service (FFS):An accountable entity is responsible for bringing the fragmented pieces of the FFS system together to meet the needs of the individual in an integrated and coordinated way. This includes responsibility for care management, administrative oversight, some element of shared savings or financial alignment, and performance measurement and reporting.