As the nation considers national health reform, this brief provides an overview of opportunities to realign federal and state policy for the dual eligibles to promote a more rational, cost-efficient system for 9 million of the poorest, sickest and highest-cost people covered by both Medicaid and Medicare.

Navigating two programs with different rules and financing incentives is complex for beneficiaries and providers, impedes efforts to improve care coordination and results in cost-shifting between programs that does not promote better outcomes.

Policy options examined in the brief include establishing a national route to provide financial assistance for low-income Medicare beneficiaries; developing systems that provide integrated acute and long-term services and supports; increasing the availability of home and community-based services; and providing more stable financing for coverage of this population.

Issue Brief (.pdf)