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Integrating Care for Dually Eligible Beneficiaries: Background and Context

Combined, Medicaid and Medicare cover a broad range of health care services. But these programs were not designed to work together. Covering individuals under two programs can result in fragmented care and promote cost shifting instead of ensuring that beneficiaries receive services that best meet their needs. Meanwhile, dually eligible beneficiaries are at particular risk during the COVID-19 pandemic due to their age and underlying medical conditions.

Chapter 1 sets the stage for the first set of policy issues laid out in the June 2020 report: how to better integrate Medicaid and Medicare benefits to improve the care experience and health outcomes for the 12.2 million individuals who are dually eligible for both programs. The chapter provides important context for the policy options and recommendations presented in Chapter 2.

From: June 2020 Report to Congress on Medicaid and CHIP