Integrating care for dual eligibles offers a significant opportunity to improve care and control rising health care costs, but progress in this area has been slow. This policy brief explores alternative strategies to integrate care for this high-need, high-cost population. With support from The Commonwealth Fund, CHCS commissioned Sara Rosenbaum, Jane Hyatt Thorpe, and Sarah Schroth at George Washington University’s Department of Health Policy to analyze the current legal and regulatory barriers and uncover alternative strategies for integrating care.

The resulting brief examines potential administrative and/or legislative changes that foster integration while permitting Medicare and Medicaid to share in any savings. The brief outlines promising opportunities to integrate care within three areas: (I) current state plan options and potential approaches to health system improvement; (II) achieving integration through current and potential demonstration and waiver authorities; and (III) options for legislative consideration.

As policymakers look to transform the nation’s health care system, there are unprecedented opportunities to support integration for duals. These include alternatives that can be implemented under existing policy, and new approaches that are worth considering at the federal level. This brief provides a comprehensive overview of options for states looking for innovative models to integrate care.