CMS Issues Guidance to Help States Better Serve People with Medicare and Medicaid

Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a Dear State Medicaid Director letter highlighting ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid.

Medicaid is an important source of coverage for nearly 12 million people with Medicare. It covers needed services that Medicare does not, such as long-term care. Medicaid also helps make Medicare more affordable by helping pay Medicare premiums and/or cost-sharing, which can be high for people with low incomes.

Helping states navigate these complementary programs in ways that prioritize the health and economic security for dually eligible individuals is critical, as this population tends to have greater medical needs and functional limitations than other Medicare beneficiaries. People with Medicaid experience relatively high rates of chronic illness, with many having multiple chronic conditions and/or social risk factors.  In addition, more than 60% need help with daily self-care activities, nearly 60% have a cognitive or mental impairment, and about 50% use long-term services and supports (LTSS).

The opportunities outlined in this letter — none of which require complex demonstrations or Medicare waivers — include new developments in managed care, using Medicare data to inform care coordination and program integrity initiatives, and reducing administrative burden for dually eligible individuals and the providers who serve them.

We welcome CMS’ efforts to identify and clarify ways the federal government and states can work together to enhance beneficiary experiences. In particular, we appreciate CMS outlining steps states can take to improve the Medicare Part A Buy-in Program, as well as to simplify the eligibility and enrollment processes for Medicare Savings Programs. We encourage policymakers to consider these and other changes that would better serve people Medicare, and look forward to continuing our work together in pursuit of this goal.

Read the Dear State Medicaid Director letter.

Learn more about Medicaid and Medicare from Medicare Interactive.

Read Medicare Rights Fact Sheet, Protect and Strengthen: Medicare and Medicaid.