About Care Coordination

Medicare-Medicaid Coordination Office

Advancing Care for People with Medicare and Medicaid

The Centers of Medicare and Medicaid’s (CMS) Federal Coordinated Health Care Office, also known as the Medicare-Medicaid Coordination Office (MMCO), serves people who are dually eligible for Medicare and Medicaid. MMCO’s goal is to ensure that these dually eligible individuals have full access to seamless, high-quality healthcare and to make the system as cost-effective as possible.

CMS-MMCO works with the Medicaid and Medicare programs, federal agencies, state Medicaid agencies, and stakeholders to align and coordinate benefits between the two programs effectively and efficiently. MMCO also partners with states to develop new care models and improve the ways that dually eligible beneficiaries receive healthcare.

Medicare Data Available to States

State Medicaid agencies may request timely access to certain Medicare data for dually eligible individuals to support care coordination. Having access to Medicare data is an essential tool for states seeking to coordinate care, improve quality, and control costs for dually eligible beneficiaries. Data that may be requested, subject to procedural limitations, are:

  • Medicare Parts A and B claims and Part D prescription drug event data.
  • Medicare Parts A, B, C, and D eligibility and enrollment data.
  • Assessments data including Minimum Data Set (MDS), Outcome and Assessment Information Set (OASIS), Swing Bed, and Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI).
  • Medicare Provider and Analysis Review (MedPAR) and Medicaid Enrollee Supplemental File (MESF) data.

For background information on the Medicare data available to states for care coordination for dually eligible beneficiaries, please download the Access to Medicare Data to Coordinate Care for Dually Eligible Beneficiaries” memorandum.

Download the Memorandum

Additional information on Medicare data available to states for care coordination for dually eligible beneficiaries  can be found at the “Integrated Care Resource Center (ICRC) website”.

Visit the ICRC Website