This presentation outlined a draft chapter for the June 2023 report to Congress on integrating Medicaid and Medicare coverage and how different delivery mechanisms provide varying levels of integration for people who are dually eligible for Medicaid and Medicare. The chapter describes the different delivery mechanisms that states use to provide Medicaid coverage to dually eligible beneficiaries and opportunities for integration. The review of delivery systems is grouped into three categories: Medicaid fee-for-service, Medicare Advantage dual eligible special needs plans, and Medicare-Medicaid Plans (MMPs) under the Financial Alignment Initiative. The chapter also highlights the changing integrated care landscape amid the sunset of the MMP model and is informed by insights from beneficiaries about their experience receiving coverage through integrated care models. The presentation concluded with next steps in the Commission’s ongoing work to advance integrated care for dually eligible beneficiaries.
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Medicaid and CHIP Payment and Access Commission
