June 12, 2019
Roughly 12 million Americans are eligible for both Medicare and Medicaid (e.g., dual eligibles). Dual-eligible individuals with long-term service and support (LTSS) needs often receive fragmented care, resulting in inefficiencies, unnecessary costs, and poorer outcomes.
Integrated, managed Medicaid long-term services and supports (MLTSS) help states achieve greater value for beneficiaries and taxpayers, making the most of scarce resources. Recent evaluations of the CMS Financial Alignment Initiative (FAI) have demonstrated the positive impact integrated plans can have on healthcare utilization, Medicare expenditures, and plan member satisfaction in several states. These evaluations suggest that integrated plans can improve beneficiaries’ lives while also reducing the need for expensive healthcare and LTSS services.