Today, across the United States, more than 12 million people are dually eligible for both Medicare and Medicaid. Each of these programs is governed by its own delivery, financing, and administrative policies and dually eligible individuals are largely left to navigate a fragmented uncoordinated system of care on their own. Integrated care models are designed to help dually eligible individuals maneuver this confusing landscape.

There are currently three different types of fully integrated care models: the Program of All Inclusive Care for the Elderly (PACE); Fully Integrated Dual Eligible Special Needs Plans (FIDE-SNPs); and Medicare-Medicaid Plans (MMPs) created under the federal Financial Alignment Initiative. While there is a growing evidence base for the effectiveness of these programs, relatively few dually eligible beneficiaries are enrolled in one of these programs.

The Better Care Playbook spoke with Jose Figueroa, MD, MPH, assistant professor of health policy and management at Harvard School of Public Health, assistant professor of medicine at Harvard Medical School, and associate physician at Brigham and Women’s Hospital, to explore who is enrolled in integrated care programs and what is known about their impacts.