With more than 12 million people in the U.S. dually eligible for Medicare and Medicaid, state policymakers are increasingly interested in enhancing care for this population to help address their often complex health and social needs. Integrating Medicare and Medicaid services for dually eligible individuals can help improve care delivery, reduce unnecessary care, and curb related costs. To develop an integrated Medicare-Medicaid program, state officials must understand Medicare’s changing regulations and policies, including how Medicare Advantage dual eligible special needs plans (D-SNPs) operate.

This Better Care Playbook webinar highlighted how California, Iowa, and Tennessee’s Medicaid agencies established Medicare knowledge to advance integrated care models. The states addressed how they are building Medicare capacity to: (1) oversee integrated programs; (2) advance health equity; and (3) respond to the evolving federal Medicare landscape. The webinar also featured a dually eligible enrollee who shared key considerations for improving Medicare and Medicaid coordination to help enrollees navigate these programs.

The featured state panelists participated in the Medicare Academy, an initiative led by the Center for Health Care Strategies (CHCS) with support from Arnold Ventures, the Commonwealth Fund, and The SCAN Foundation. The Medicare Academy provides Medicaid and partner agencies with training to build the Medicare knowledge needed to successfully advance integration goals.

Agenda

I. Welcome and Introductions

Speaker: Alexandra Kruse, Senior Fellow, CHCS

A. Kruse welcomed attendees and provided an agenda overview before introducing panelists.

II. Bridging the Medicare Knowledge Gap: State and Dually Eligible Perspectives and Experiences

A. Kruse provided an overview of state efforts to develop integrated programs for dually eligible individuals and the value of Medicare knowledge to advance integration. State officials from California, Iowa, and Tennessee reviewed their integration landscapes and shared how their states are establishing and sustaining needed Medicare capacity. Barbara Merkel, a dual-eligible enrollee, shared examples of how separate Medicare and Medicaid coverage rules and processes make it difficult to navigate care — elevating important opportunities for how these programs can work better together.

Moderator: A. Kruse

Panelists:

• Anastasia Dodson, Deputy Director, Office of Medicare Innovation and Integration, California Department of Health Care Services
• Susan Van Horn, Program Manager, Dual Eligible and Third-Party Liability Policy, Iowa Department of Health and Human Services
• Loleetha Gilbert, Assistant Director of D-SNP and PACE, TennCare
• Barbara Merkel, dually eligible enrollee

III. Moderated Q&A

Moderator: A. Kruse, CHCS