For many states, the first steps toward advancing integrated care for their dually eligible populations could be taken by building a stronger foundation for Medicare-Medicaid integration. This entails making administrative changes to Medicaid programs that: (1) support integration efforts; (2) improve beneficiaries’ experience of care; (3) decrease beneficiary out-of-pocket costs; and (4) reduce provider burden. These changes, also described in a December 2018 State Medicaid Director Letter and ICRC’s State Pathways to Integrated Care tool, include:

  • Establishing Medicare Part A Buy-In agreements with the Centers for Medicare & Medicaid Services (CMS)
  • Ensuring that state eligibility criteria for Medicare Savings Programs (MSPs) align with the Medicare Part D Low Income Subsidy Program
  • Supporting beneficiary enrollment into MSPs and Extra Help
  • Exchanging data files with CMS more frequently
  • Facilitating beneficiary access to services, such as durable medical equipment, to reduce fragmentation between the Medicare and Medicaid programs

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