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Inventory of Evaluations of Integrated Care Programs for Dually Eligible Beneficiaries

Integrating care for beneficiaries dually eligible for Medicare and Medicaid is a key priority for states and the federal government. This population has varying medical needs, must navigate two different programs for its coverage, and accounts for a disproportionate share of spending in both programs. A variety of models have evolved that seek to better integrate care for dually eligible beneficiaries; they include the Program of All-Inclusive Care for the Elderly (PACE), the Financial Alignment Initiative (FAI), Medicare Advantage dual eligible special needs plans (D-SNPs), including highly integrated dual eligible special needs plans (HIDE SNPs) and fully integrated dual eligible special needs plans (FIDE SNPs), managed long-term services and supports (MLTSS) programs, and demonstrations that pre-dated the FAI.

MACPAC commissioned the State Health Access Data Assistance Center at the University of Minnesota to conduct a systematic literature review and abstraction of studies that evaluate the impacts of these programs. This Excel spreadsheet provides a single resource for users to review available evidence regarding spending, quality, health outcomes, and access. The inventory includes a total of 83 studies, including studies published between 2004 and November 2018 and formal evaluations on the FAI updated to December 2023. The workbook is organized into several tabs including a list of common acronyms found in the studies we compiled; a summary of the key findings from each evaluation which can be sorted by model type or by state; and a tab with more detailed findings by type of service, beneficiary experience, and findings related to enrollment for anyone interested in more detail on a particular study.