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Medicare and Medicaid Integration

Distinct Medicare and Medicaid rules, funding streams, and service delivery systems can create barriers that increase costs and worsen outcomes for people who are jointly enrolled in the programs. We support correcting this fragmentation through policies that offer meaningful choice; reduce disparities in access to and quality of care; rely on active and informed enrollee participation; include robust safeguards and oversight; offer clear enrollee and provider education about options for accessing integrated care; establish unified grievance and appeals processes; ensure seamless access to data; and provide person-centered care coordination and care management.

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Improving Integrated Care for the Dually Eligible: Policy Recommendations for New York

May 16, 2024

In 2022, the New York State Department of Health (NYSDOH) released its Dual Eligible Integrated Care Roadmap, which outlined the state’s many priorities for improving integrated care for those dually eligible for Medicare and Medicaid.[i] By promoting integrated care for duals, they hoped to improve health outcomes, enhance member satisfaction, and reduce costs. One of the most ambitious goals was a 250% increase in the number of dually eligible individuals receiving integrated care through an aligned contract—meaning that the individual’s Medicare and Medicaid benefits are provided by the same company—by the end of 2023. These aligned contracts include the state’s Integrated Benefits for Dually Eligible Enrollees (IB-Dual) program and Medicaid Advantage Plus (MAP) plans.

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Improving Integrated Care for the Dually Eligible: Policy Recommendations for New York

May 16, 2024

In 2022, the New York State Department of Health (NYSDOH) released its Dual Eligible Integrated Care Roadmap, which outlined the state’s many priorities for improving integrated care for those dually eligible for Medicare and Medicaid.[i] By promoting integrated care for duals, they hoped to improve health outcomes, enhance member satisfaction, and reduce costs. One of the most ambitious goals was a 250% increase in the number of dually eligible individuals receiving integrated care through an aligned contract—meaning that the individual’s Medicare and Medicaid benefits are provided by the same company—by the end of 2023. These aligned contracts include the state’s Integrated Benefits for Dually Eligible Enrollees (IB-Dual) program and Medicaid Advantage Plus (MAP) plans.