As the COVID-19 pandemic unfolded, it became evident that Medicare-Medicaid dually eligible individuals were among the nation’s most at-risk for and vulnerable to the virus. With this group of individuals largely receiving care in uncoordinated, fragmented systems, it is critical to identify opportunities to strengthen programs and policies to best support this population during the pandemic and in the future. Integrated care programs offer opportunities to align enrollment, care coordination, and incentives across payers and providers to support positive health and care outcomes.
This report distills insights about COVID-19 response efforts from states and health plans that offer integrated programs. It outlines recommendations to support integration, including suggestions to: (1) increase alignment between Medicare and Medicaid; (2) increase health plan flexibilities to meet member needs; (3) pay family caregivers and support other efforts to expand the workforce; (4) expand supplemental benefit offerings; (5) improve communication and data sharing; and (6) ensure fiduciary oversight.