In December 2018, the Centers for Medicare and Medicaid Services (CMS) released a State Medicaid Director Letter, which outlines ten opportunities to better serve the 12 million people enrolled in both Medicare and Medicaid (dual eligibles).

Our publication summarizes and provides our initial assessment of the ten opportunities in order to provide advocates a fuller understanding of the options CMS is presenting to states. For each of the options, we describe the Center’s “take” and rate as “Yes, but monitor details,” “Proceed with Caution” or “Risky.”

While several of the opportunities outlined in the CMS letter to the states may genuinely help to reduce unnecessary administrative burden and may potentially promote integration between the two programs, some present great risk for beneficiaries.