Dual Eligible

This brief looks at states who operate Medicare-Medicaid integrated care models based on demonstrations under the federal Financial Alignment Initiative (FAI) or through Dual Eligible Special Needs Plans (D-SNPs) that are aligned with Medicaid managed care plans. It explores factors that contributed to state investment and successful program implementation. The brief also provides an overview of opportunities for other states interested in creating or enhancing integrated care programs.

This report presents highlights from a National Governor's Association Roundtable held in December 2018. At the roundtable, state and federal officials, national experts, and industry and consumer experts discussed challenges and opportunities for states to improve care and manage costs for dual eligibles. Based on the conversation at this event, NGA identifies key considerations for governors and their staff.

CMS regularly reports data on health plan enrollment, quality, and compliance that states can use to monitor the performance of the Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) they contract with to serve Medicare-Medicaid enrollees. This technical assistance tool shows how states can use these data to create tables, graphs, and figures and interpret their meaning in order to assess D-SNP performance.