HMA briefs on Medicare-Medicaid integration
July 23, 2021
This issue brief from Health Management Associates, Medicare-Medicaid Integration: Essential Program Elements and Policy Recommendations for Integrated Care Programs for Dually Eligible Individuals is part of a multi-phased research initiative to increase enrollment in integrated care programs (ICPs) that meet full benefit dually eligible individuals’ needs and preferences. Dually eligible individuals have a range of chronic conditions and disabilities requiring both Medicare and Medicaid services, which makes integrated programs important to their lives.
For a succinct overview of the essential elements and policy recommendations, please access the brief fact sheet. For a full discussion of the elements and policy recommendations, please access the full brief.
The authors are Sarah Barth, Ellen Breslin, Samantha DiPaola and Narda Ipakchi.
For further information or questions, contact Sarah Barth at firstname.lastname@example.org, Ellen Breslin at email@example.com, or Samantha DiPaola at firstname.lastname@example.org.
 Integrated Care Programs (ICPs): For this research, we defined ICPs as financing and care delivery organizing entities or programs that coordinate and integrate Medicare and Medicaid-covered services and supports for dually eligible individuals.They include the Centers for Medicare & Medicaid Services (CMS) Financial Alignment Initiative (FAI) capitated and fee-for-service models; the Program of All-Inclusive Care for the Elderly (PACE); Medicare Advantage (MA) Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs); Medicaid Managed Long-Term Service and Supports Program (MLTSS) managed care organizations and aligned MA dual eligible special needs plans (D-SNPs); and state-specific programs that may be proposed to CMS.
 Dually Eligible Individuals: When using the term dually eligible individuals, we are referencing Medicare-Medicaid full benefit dually eligible individuals (FBDEs), those who qualify for full Medicaid benefits.
 Narda Ipakchi was formerly a Senior Consultant with HMA.