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Establishing a Unified Program for Dually Eligible Beneficiaries: Design Considerations

Chapter 4 continues the Commission’s work on integrating care for individuals who are dually eligible for Medicaid and Medicare. Individuals who are dually eligible for Medicaid and Medicare often experience fragmented care and poor health outcomes due to lack of coordination across the two programs. A unified program could simplify coverage for beneficiaries, providing care and services under a single umbrella. It also has the potential to reduce federal and state spending on these individuals.

This chapter examines many of the policy and design issues and policy trade-offs that would need to be settled in developing a unified program. MACPAC draws on the work of two stakeholder groups—the Bipartisan Policy Center and the Dual Eligible Coalition convened by Leavitt Partners—that are promoting a new approach to serving this population.

From: March 2021 Report to Congress on Medicaid and CHIP