As the federal government and states shift from the Financial Alignment Initiative to other models of integrated care, such as Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs), more information is needed to stimulate conversation among advocates, state and federal policymakers, and other stakeholders responsible for ensuring that dually eligible individuals have access to all Medicaid and Medicare benefits in a whole, person-centered manner.  

Community Catalyst’s Center for Community Engagement in Health Innovation partnered with the Disability Policy Consortium to publish two issue briefs focused on ensuring an equity-centered model of care for individuals that are dually eligible for both Medicare and Medicaid. 

The briefs highlight ways for states to leverage their state Medicaid agency contracts (SMACs) with D-SNPs, to advance independent living and recovery models, and health equity. States can include any requirements in their SMACs, as long as they do not conflict with federal law.  

The first brief, “The Financial Alignment Initiative (FAI) Demonstration: How Four States Are Navigating the New Policy Landscape for Integrated Care Programs” summarizes information on how four FAI demonstration states are designing, developing, and implementing new integrated care programs.  

Read the Brief Here

The second brief, “A Call for Equity: Re-Committing to an Independent Living and Recovery Centered Model of Care” focuses on the evolution required in the model of care to advance disability rights in keeping with the goals of the independent living and recovery movements. These movements led to the creation of home and community-based services (HCBS), the deinstitutionalization of persons with mental health diagnoses, and the ongoing shift in our understanding of substance use to a more whole-person understanding of addiction. 

Read the Brief Here

Resources

Improving the Access and Outcomes of Home and Community-Based Services (HCBS) Use Among Older Adults of Color Enrolled in Both Medicare and Medicaid

The Administration for Community Living projects that the number of older adults who identify as African American, American Indian and Alaska Native, Asian, and Hispanic is expected to grow by 115% by 2040. Because people are living longer, it is more likely that they will experience the need for long-term services and supports (LTSS). Is the system currently meeting their needs and is it robust enough to address growing future needs? The research presented in this project suggests that it is not.

Read more here

New Research Details Specific Recommendations for CMS, Others, on Making Dual Eligible Enrollment Person-centered

People dually eligible for Medicare and Medicaid face overwhelming enrollment decisions that significantly impact their health outcomes. Not only do they face an increasingly complex, integrated care enrollment landscape, they have limited trusted resources to turn to for assistance. In response, the Center for Community Engagement in Health Innovation at Community Catalyst (the Center) unveiled new research and recommendations informed by listening sessions with both people with lived experience as well as deep policy expertise to help the federal government create a better system that responds to the needs and preferences of the community it serves.

Read more here

Centering the Perspective of Older Adults and the Disability Community in New Health and Housing Federal Partnerships

Housing and supportive services are key pillars to full community integration for people with disabilities, yet they remain chronically underinvested. As a result, more than 30 years after the passage of Americans with Disabilities Act, many of the original aims of the legislation remain unachieved for many people with disabilities, especially those with low incomes. Low-income older adults are increasingly cost burdened, with Black and Latinx older adults more likely to experience severe cost burdens. This report by The Center for Consumer Engagement in Health Innovation at Community Catalyst explores policy options for the integration of older adults and identifies five key building blocks for success towards health and housing systems that effectively serve those most in need of support.

Read more here