CMS’s Integration Agenda: Why LTSS Providers Must Evolve from Vendors to Strategic Partners
For years, long-term services and supports (LTSS) providers have operated primarily as Medicaid service providers. That model is beginning to change
For years, long-term services and supports (LTSS) providers have operated primarily as Medicaid service providers. That model is beginning to change
Artificial intelligence is rapidly transforming Medicare-Medicaid dual eligibility operations. New AI-powered platforms are helping health plans automate D-SNP enrollment, improve Medicaid eligibility verification, reduce coverage gaps, and strengthen compliance.
For aging and disability advocates, integration is not a technical policy debate—it is a prerequisite for dignity, independence, and survival in the community. As the population of individuals dually eligible for Medicare and Medicaid (“duals”) continues to grow, fragmented systems are increasingly misaligned with the realities of aging, disability, and chronic need.
While long-term services and supports (LTSS) for older adults often dominate discussions in dual-eligible policy, equally urgent conversation is taking shape around individuals with intellectual and developmental disabilities (IDD)
As we move through 2025, the evolving landscape of Long-Term Services and Supports (LTSS) policy demands urgent attention.
Dual-eligible beneficiaries—individuals who qualify for both Medicare and Medicaid—represent one of the most complex patient populations in the U.S. healthcare system. They often have multiple chronic conditions, disabilities, and social determinants of health (SDOH) that make coordinating their care a significant challenge.
Dual-eligible beneficiaries—12.5 million Americans qualifying for both Medicare and Medicaid—represent a vulnerable population with complex healthcare needs, accounting for disproportionate healthcare spending and facing significant challenges in care coordination and access to comprehensive, integrated health services.
Dual-eligible programs serve a critical role in the healthcare system, providing integrated care for individuals who qualify for both Medicare and Medicaid. These individuals often face complex medical needs and financial challenges, yet the existing systems can be fragmented, leading to poor health outcomes.
Dual-eligible programs serve a critical role in the healthcare system, providing integrated care for individuals who qualify for both Medicare and Medicaid. These individuals often face complex medical needs and financial challenges, yet the existing systems can be fragmented, leading to poor health outcomes.
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