New York, NY —The Medicare Rights Center, a national nonprofit consumer service organization, released a new report titled “Improving Integrated Care for the Dually Eligible: Policy Recommendations for New York.” The report examines obstacles faced by older adults and people with disabilities who are dually eligible for Medicare and Medicaid and enrolled in integrated care plans in New York.   

The report draws on real experiences from the Medicare Rights Center’s helpline to highlight common pitfalls with integrated care products like Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs). Issues identified include lack of education on plan options, confusing enrollment processes, benefit coverage gaps, and misaligned provider networks. 

“While New York has made strides to improve integration of Medicare and Medicaid benefits, our report shows more must be done to improve the consumer experience,” said Fred Riccardi, President of the Medicare Rights Center. “Dually eligible individuals often struggle to navigate the complex integrated care landscape and end up losing access to needed services.” 

The report outlines six key recommendations for New York policymakers, including developing better educational materials, preventing loss of long-term care coverage when changing plans, achieving 100% provider network congruency, improving plan benefit explanations, and enhancing stakeholder engagement processes. 

“Integrated care holds great promise for improving health outcomes and reducing costs, but only if it is truly integrated and consumer friendly,” Riccardi said. “Thanks to our organization and partners’ advocacy, New York has led the way in ensuring that more people are fully dual eligible. We now urge the state to adopt our recommendations to make integrated care work better for all dually eligible New Yorkers.” 

The full report is available on the Medicare Rights Center’s website at www.medicarerights.org/policy-documents/improving-integrated-care-for-the-dually-eligible-policy-recommendations-for-new-york.