The federal government and states are testing a variety of models to integrate care for beneficiaries enrolled in both Medicare and Medicaid. They include the Program of All-Inclusive Care for the Elderly, the Financial Alignment Initiative (FAI), Medicare Advantage dual eligible special needs plans and fully integrated dual eligible special needs plans, managed long-term services and supports programs, and demonstrations that pre-dated the FAI.
There is a limited but growing body of evidence examining the effects of these models on Medicare and Medicaid spending, health outcomes, and access to care. In this issue brief we highlight findings from the research literature. Broadly, studies to date have generally found a decrease in hospitalizations and readmissions for enrollees in the different models relative to those not enrolled in integrated models. Findings regarding use of other services, such as use of the emergency department and long-term services and supports, were mixed as are reports on beneficiary experience. It is often difficult to generalize from evaluations of specific models about the effects of integrated care more broadly.
For the full literature review, review the inventory of existing evaluations of integrated care models compiled by the State Health Access Data Assistance Center at the University of Minnesota under contract for MACPAC: Inventory of Evaluations of Integrated Care Programs for Dually Eligible Beneficiaries.