Funder: ADvancing States

Author: Nancy Archibald and Michelle Herman Soper, Center for Health Care Strategies; and Camille Dobson, ADvancing States

May 2020 | Brief


For the past decade, policymakers have sought better integration of Medicare and Medicaid for individuals who are eligible for both programs. Yet, despite progress made by states, their federal partners, and health plans, about 90 percent of the approximately 12 million dually eligible individuals in the U.S. are still receiving fragmented, uncoordinated care.

Several states are interested in pursuing new opportunities to improve care for dually eligible beneficiaries, but some states are new to integration and may not know where to start. This brief, developed by CHCS through support from ADvancing States, outlines key questions for states to consider as they explore options for better coordinating care delivery for this population. It is designed to support states in selecting a realistic and achievable integration approach, while also meeting their policy goals.