This research finds that two-thirds of the states either have or will launch new initiatives to better coordinate care for people who are dually eligible for Medicare and Medicaid services, the so-called "duals," over the next two years.  To contain the growth of costs and improve care, many of them are moving to risk-based managed long-term services and supports models.

The federal government, in partnership with many states, is exploring models to better serve duals and align the Medicaid and Medicare programs to remove adverse incentives and improve care coordination. This research, based on a survey of 50 states and the District of Columbia conducted in the fall of 2012,  also finds that some states are taking the opportunity extended by the Centers for Medicare & Medicaid Services (CMS) to test new models, but a number of states are exploring or implementing alternative approaches to dual services integration outside of the CMS models.