A Guide for State Advocates: State Demonstrations to Integrate Medicare and Medicaid

“Dual eligibles” have both Medicare and Medicaid. They are often the sickest and most vulnerable patients. And since neither program coordinates their care, this group has problems getting care in the appropriate setting and receives unnecessary tests and treatments. The Affordable Care Act provides new opportunities to improve coordination between Medicare and Medicaid, and it created two new offices that will help carry out these new opportunities.

This guide:

• explains the requirements for state demonstrations that integrate care for dual eligibles
• discusses models of integration and issues to consider with each model
• provides guidance on getting involved in the planning process