As of January 2020, more than one-third of states operate Medicare-Medicaid integrated care models based on demonstrations under the federal Financial Alignment Initiative or through Dual Eligible Special Needs Plans that are aligned with Medicaid managed care plans. Although enrollment in integrated care models has increased nearly five-fold in the past decade, fewer than 10 percent of the 12 million Americans who are dually eligible for Medicare and Medicaid are currently enrolled in an integrated program. To serve more dually eligible individuals, more states will need to develop integrated care programs, and existing programs will need to increase in scope.
This brief, made possible with support from The SCAN Foundation, examines the progress of states that were early implementers of integrated care models. It identifies key factors that drove the successful implementation of these programs and highlights opportunities for other states interested in creating or enhancing integrated care programs.