Beneficiary Protections Central to a Meaningfully Integrated Coverage and Care Experience for Individuals Who Are Dual Eligible

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AUTHOR – ATI Advisory

With support from Arnold Ventures, ATI Advisory conducted listening sessions, focus groups, and interviews with diverse stakeholders to better understand the unique needs and experiences of individuals who are dual eligible for Medicare and Medicaid, and their caregivers. Through these conversations, ATI gained insights on the potential role that integrated coverage and care experiences can play in addressing the concerns of individuals who are dual eligible and their caregivers. Central to what we heard: individuals who are dual eligible and their caregivers seek a person-centered and seamless consumer experience.

In this policy brief, we include specific comments from individuals who are dual eligible and their caregivers. Where available, we have identified policy and program considerations responsive to the feedback. We have also included a one-page summary of the key challenges we hard dual eligible individuals face when accessing care.

Recent Work


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Many individuals in the United States access long term services and supports (LTSS) through Medicaid. But for Medicare beneficiaries without Medicaid, LTSS-like supplemental benefits offered by Medicare Advantage (MA) plans can help increase access to LTSS. This ATI Advisory data brief examines whether access to and enrollment in MA plans offering LTSS-like supplemental benefits differs meaningfully by demographic characteristics, including age, gender, race and ethnicity, and geography.
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Opportunities to Improve Quality of Life and Health Outcomes Among People Experiencing Incontinence

ATI analyzes the prevalence of incontinence among dual eligible individuals, and highlights services and products that can help individuals manage their incontinence.
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Many Medicare beneficiaries could benefit from a model like Program of All-Inclusive Care for the Elderly (PACE) that offers comprehensive Medicare and Medicaid benefits to frail, older adults who want to remain living in the community. However, many older adults on Medicare do not have Medicaid coverage, making PACE less affordable to them.
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See more Work
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