Integrated Care Programs for Dually Eligible Individuals in the Era of COVID-19: Response Efforts and Policy Recommendations

Brianna Ensslin Janoski
Tom Betlach
Michelle Herman Soper
September 2020

The COVID-19 pandemic has profoundly affected individuals who are dually eligible for Medicare and Medicaid, many of whom have risk factors for adverse COVID-19 related outcomes. These individuals often have significant medical, behavioral health, and long-term care needs and may receive care in uncoordinated, fragmented systems. This report distills insights about COVID-19 response efforts from states and health plans that have integrated programs, which can support positive outcomes through opportunities to align enrollment, care coordination, and incentives across payers and providers.

Recommendations to support integration amid the pandemic and beyond include to: (1) increase alignment between Medicare and Medicaid; (2) increase health plan flexibilities to meet member needs; (3) pay family caregivers and support other efforts to expand the workforce; (4) expand supplemental benefit offerings; (5) improve communication and data sharing; and (6) ensure fiduciary oversight. It remains critical for states and plans to continue to strengthen existing and identify new programs and policies that address heightened medical and social needs.

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