Committed to advancing federal policies that promote integration of care for individuals dually eligible for Medicare and Medicaid

About The Coalition

The Dual Eligible Coalition is a group of multi-sector stakeholders including beThe Dual Eligible Coalition is a group of multi-sector stakeholders including beneficiary advocates, managed care plans, provider systems, and behavioral health and social support service organizations that is informed by state advisors. The Coalition was founded to develop actionable, long-term policy and programmatic solutions to improve the delivery of care and outcomes for the dual eligible population. 

The Coalition has been at work to assess the challenges and opportunities facing the dual eligible population and the stakeholders who work with or serve them, including states. As states strive to improve care for their dual eligible populations, they require additional resources, as well as technical assistance in delivering integrated care to their dual eligible populations. The Coalition has developed a framework for fully integrating Medicare and Medicaid into a single program addressing medical, long-term care, behavioral, and social needs. 

In addition to developing the framework, the Coalition is working to increase awareness of the needs of dual eligibles among policymakers, and the need for resources and technical support for states who deliver care to dual eligible populations. 

In conducting its work, the Coalition seeks to promote a set of principles around integration and whole-person care, including the following: 

• Supporting Beneficiaries to Live as Fully as Possible 
• Ensuring Comprehensive Integration 
• Promoting State-Federal Partnership 
• Ensuring Robust Reporting, Accountability, and Continuous Quality Improvement 
• Aligning Incentives for Value-Based Care 
• Promoting Consumer Engagement 

The Coalition’s framework was developed through Coalition members’ input and expertise, as well as a structured stakeholder outreach process in which Leavitt Partners facilitated more than 40 individual conversations with a wide array of diverse stakeholders across the health care community, including with policy experts, providers, advocates, associations, and foundations.  

The Opportunity to Improve Care

There are more than 12 million dual eligible beneficiaries enrolled in both Medicare and Medicaid. This is a diverse population that includes people with multiple chronic conditions, developmental and physical disabilities, mental illness, cognitive impairments, and social needs.

Both MedPAC and MACPAC have noted concerns raised as to how the existence of separate funding streams creates barriers to coordination of care and the extent to which lack of coordination increases costs and leads to poor health outcomes. Numerous researchers, health policy experts, states, and stakeholders have expressed interest in seeing more aligned incentives and integrated care to improve health outcomes and quality of care for dual eligible beneficiaries.

The Comprehensive Care for Dual Eligible Individuals Act

The Coalition was proud to support Sen. Sherrod Brown’s (D-OH) and Sen. Rob Portman’s (R-OH) bill, The Comprehensive Care for Dual Eligible Individuals Act of 2022. The bill sought to provide states with the option to develop an All-Inclusive, Integrated Medicare-Medicaid (AIM) Program, which provides state an option to—with robust CMS oversight—administer a single integrated program for full benefit dual eligible beneficiaries, such that beneficiaries would no longer have to navigate separate programs to meet their complex needs The Coalition supported this legislation as a critical step for states to integrate program financing, administration, eligibility processes, and benefits to create the fullest, most integrated benefit possible for full benefit dual eligible beneficiaries, and is continuing to work toward its reintroduction.  

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Our Members