A call to improve care for people with both Medicare and Medicaid

Some of the sickest and most vulnerable patients in the U.S. qualify for both the Medicare and Medicaid programs. But navigating the complex and confusing rules and regulations of the two programs can be daunting, according to Harvard T.H. Chan School of Public Health’s Jose Figueroa.

In February 10, 2022 testimony before the U.S. Senate Special Committee on Aging, Figueroa, assistant professor of health policy and management, argued that the federal government should work to create greater integration across the payment, delivery, and administration of health care services between Medicare, a federal health insurance program that serves people over age 65 and those with disabilities, and Medicaid, a federal-state program that provides health coverage for low-income individuals.

Figueroa noted that the roughly 12.3 million dual-eligible patients in the U.S. live with disability, serious mental illness, frailty, multiple chronic conditions, and often live in poverty. They are at greater risk for experiencing poor quality of care, limited health care access, and, ultimately, worse health outcomes.

He made a number of recommendations aimed at making it easier for them to access both their Medicare and Medicaid benefits.

For example, he suggested that Congress offer states guidance, technical assistance, and financial support to move towards adoption or expansion of models that integrate care between the two programs. He also recommended that integrated care models provide better value for patients and that the enrollment process be simplified.

Listen to or read Figueroa’s Senate testimony: Improving Care Experiences for People with both Medicare and Medicaid (Figueroa’s testimony begins at 29:25)