Chapter 5 takes an important step forward in making integrated care a standard for the 12.2 million people who are dually eligible for Medicaid and Medicare. While integrating care for beneficiaries of these programs has the potential to improve care and reduce federal and state spending, only about 1 million full-benefit dually eligible beneficiaries were enrolled in integrated care models in 2020. Moreover, some states are further along than others in integrating care for these beneficiaries. To raise the bar on integration, the Commission recommends requiring all states to develop an integrated care strategy within two years.
The strategy should address how the state will approach integration, eligibility, and benefits covered, enrollment strategy, beneficiary protections, data analytics, and quality measurement—and be structured to promote health equity. The recommendation includes federal financing to support states in developing the strategy.
From: June 2022 Report to Congress on Medicaid and CHIP