States play a vital role in improving care and outcomes for the dual-eligible population, but support is often needed. States have the ability to offer models that integrate Medicare and Medicaid, but many barriers currently exist for states seeking to adopt these models. Advancing Medicare & Medicaid Integration is an initiative supported by Arnold Ventures and coordinated by the Center for Health Care Strategies (CHCS) that is targeted to states ready to make meaningful transformations in care delivery for individuals eligible for both Medicare and Medicaid. This includes states that operate demonstrations under the federal Financial Alignment Initiative and are looking to transition to more permanent integration strategies and states without demonstrations that are looking to build on or adopt integrated options.

Following are profiles of state projects already underway supported by Arnold Ventures to advance Medicare-Medicaid integration. To learn more about funding opportunities under Advancing Medicare & Medicaid Integration, states are encouraged to read about the types of projects that can be supported through this initiative. States may also contact CHCS by email to discuss their goals for integration.

• Hawaii Department of Human Services, Med-QUEST Division in Partnership with ATI Advisory (August 2022) – Working to advance integration by enhancing the state’s D-SNP platform, improving care coordination for select populations, and informing MLTSS program design via increased understanding of the Medicare fee-for-service population.
• Indiana Family and Social Services Administration (May 2022) – Working to design a Medicare-Medicaid integration strategy for dually eligible individuals enrolled in Medicaid managed long-term services and supports.
• Nevada Department of Health and Human Services, Division of Health Care Financing and Policy (April 2023) – Working to improve integration and oversight of D-SNPs by identifying opportunities to strengthen and integrate D-SNP contracts.
• North Carolina Department of Health and Human Services in Partnership with Duke-Margolis Center for Health Policy (June 2021) – Collaborating to identify options for an integrated care model and an implementation pathway that aligns with ongoing Medicaid transformation efforts.
• Tennessee Bureau of TennCare in Partnership with Altarum Medicare-Medicaid Services for States (June 2023) – Working to advance the quality and experience of care, health equity, and cost efficiency of services for full-benefit D-SNP enrollees, as well as increase enrollment in FIDE SNPs that are aligned with TennCare plans to improve access to coordinated and integrated care.
• Washington Department of Social and Health Services (May 2022) – Applying lessons from its demonstration under the federal Financial Alignment Initiative to increase enrollment in its Medicare-Medicaid integrated care programs.