Medicare-Medicaid Integration: Essential Program Elements for Integrated Care Programs for Dually Eligible Individuals
Source: Health Management Associates
Brief  |  July 2021

Programs that integrate Medicare and Medicaid are a promising approach to provide services and supports for individuals dually eligible for these two programs, and to enable them to achieve higher quality of life and preferred outcomes. Yet, the availability of integrated care programs is relatively low, and only 1 in 10 dually eligible individuals is enrolled in such a program.

This brief identifies 10 essential elements for establishing and simplifying integrated care programs and provides recommendations for federal and state policy changes and resource supports needed to incorporate these elements into integrated care programs. The elements are organized into three categories: eligibility and enrollment; delivery of care and supports; and critical consumer access.

Posted: June 2023