One major barrier to the growth of Medicare-Medicaid integration is the lack of clear financial incentives for states to pursue developing them. This report highlights two existing strategies that states can use to improve the financial integration of Medicare and Medicaid and, potentially, to allow states to share in Medicare savings resulting from Medicaid investments. These strategies present opportunities to improve the financial integration of Medicare and Medicaid to discourage cost-shifting across programs, incentivize states to pursue more integrated care models for dual-eligible individuals, and ensure that care delivery across the two programs is as seamless and unified as possible for the beneficiary.