As CMS and states continue pushing toward deeper Medicare–Medicaid integration, health plans are under growing pressure to evolve beyond traditional D-SNP models and build truly coordinated systems of care for dual-eligible members.
Integration is more than a regulatory requirement. It is an operational transformation that touches nearly every aspect of a health plan, from care coordination and provider alignment to data sharing, member experience, and value-based strategy.
In this discussion, Sellers Dorsey Senior Director, Joe McGrath, joins former health plan executive, Karen Brach, to explore:
- Why the Medicare–Medicaid intersection remains one of the most complex areas in healthcare
- How Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs) differ from historical D-SNP models
- Where organizations are struggling as they attempt to operate across Medicare and Medicaid
- What leadership teams should be doing now to build sustainable, integrated models for the future
The conversation also examines one of the most important, and often overlooked, drivers of successful integration: provider incentive alignment.
With decades of experience across Medicaid, Medicare Advantage, and health plan operations, Joe and Karen bring both strategic and operational perspectives to the realities health plans are facing today as the dual market continues to evolve.
For a deeper look at the operational capabilities, organizational maturity models, and practical steps required to advance D-SNP integration, download our D-SNP Integration Playbook for Health Plans.
