Many of the more than 11 million individuals enrolled in both Medicare and Medicaid have complex health care needs, but receive services in separate, unaligned, and uncoordinated delivery systems. To address long-standing problems with Medicare-Medicaid integration, many states are participating in the Financial Alignment Initiative sponsored by the Centers for Medicare & Medicaid Services and others are pursuing alternative approaches to integration such as contracting with Medicare Advantage Dual Eligible Special Needs Plans.

INSIDE, supported by The Commonwealth Fund and The SCAN Foundation, supported and connected states, federal officials, health plans, and provider partners to advance models that integrate Medicare and Medicaid. Through three project phases, CHCS provided participating states with a platform for shared learning and opportunities for peer-to-peer exchange and dialogue between states and federal officials:

  • INSIDE III (2017) worked with 10 states — Arizona, Illinois, Massachusetts, Minnesota, New Jersey, Ohio, Rhode Island, South Carolina, Tennessee, and Virginia — advancing Medicare-Medicaid integration through financial alignment demonstration programs and/or contracts with Dual Eligible Special Needs Plans.
  • INSIDE II (2014-2017) worked with 14 states — Arizona, California, Florida, Idaho, Massachusetts, Minnesota, New Jersey, New York, Ohio, Rhode Island, South Carolina, Texas, Virginia, and Washington — that were in the implementation and oversight phase of their integrated care programs to refine and accelerate their efforts.
  • INSIDE I (2013-2014) brought together 16 states — Arizona, Arkansas, California, Colorado, Idaho, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, Pennsylvania, Rhode Island, South Carolina, Texas, Virginia, and Washington — to help them design and launch integrated care programs or other innovations for Medicare-Medicaid enrollees.

The tools and resources developed to support the states participating in INSIDE were disseminated broadly to help additional states pursue integrated care for Medicare-Medicaid enrollees.