Forum Session

Coordinating Care for Beneficiaries Eligible for Both Medicare and Medicaid: An Update on the "Duals Demos"
October 30, 2015


Sally Coberly, PhD


The Financial Alignment Initiative (FAI) demonstration authorized under the Patient Protection and Affordable Care Act of 2010 (ACA) allows states to integrate Medicare and Medicaid financing streams and benefits for individuals eligible for both programs—the "duals." Duals account for a disproportionate share of spending in both programs, and some experts believe that improving coordination between the two programs can lead to better outcomes for beneficiaries and reduce costs. As of July, over 400,000 duals in 11 states were enrolled in the FAI demonstration, using either a capitated or managed fee-for-service approach. This Forum session provided an overview of the FAI demonstration, reviewed the implementation experiences of one state, looked at implementation from the perspective of beneficiaries and their families, and described efforts to help participating health plans and providers incorporate geriatrics best practices into the care delivered to duals.


Tim Engelhardt (bio)
Director, Medicare-Medicaid Coordination Office, Centers for Medicare and Medicaid Services

Karen E. Kimsey, MSW (bio)
Deputy Director for Complex Care Services, Virginia Department of Medical Assistance Services

Renée Markus Hodin, JD (bio)
Director, Voices for Better Health, Community Catalyst

Gregg Warshaw, MD (bio)
Clinical Professor, Department of Family Medicine, University of North Carolina

Related Materials

MaryBeth Musumeci, "Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS," Issue Brief, Kaiser Family Foundation, September 8, 2015.

Kaiser Family Foundation, "Health Plan Enrollment in the Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries," fact sheet, August 6, 2015.

For more information about the Financial Alignment Initiative, including each participating state's memorandum of understanding (MOU), see the website.

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