{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:15:26Z","timestamp":1777932926987,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS029453"],"award-info":[{"award-number":["R01HS029453"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014848","name":"Arnold Ventures","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014848","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["RF1AG088640"],"award-info":[{"award-number":["RF1AG088640"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Care Res Rev"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>Medicare and Medicaid are separate programs that together cover 13 million low-income older adults and people with disabilities, known as dual-eligible individuals. Concern about a lack of coordination across Medicare and Medicaid has prompted the development of Integrated Care Programs (ICPs). Although the primary goal of ICPs is to coordinate financing and care across Medicare and Medicaid, ICPs may also influence whether low-income individuals obtain or keep Medicaid. We evaluated whether the rollout of Medicare-Medicaid Plans (MMPs)\u2014one of the largest ICPs\u2014was associated with changes in Medicaid take-up and retention among Medicare beneficiaries residing in high-poverty zip codes. Using a stacked difference-in-differences design and variation in MMP rollouts across nine states, we found no evidence that MMPs increased monthly or continuous Medicaid enrollment in this population. These findings highlight the need for focused policies to address Medicaid enrollment gaps among low-income Medicare beneficiaries, which could complement broader integration efforts.<\/jats:p>","DOI":"10.1177\/10775587251372267","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T11:51:59Z","timestamp":1759405919000},"page":"20-32","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Dual-Eligible Integrated Care Plans on Medicaid Enrollment and Retention: Evidence From the Implementation of Medicare-Medicaid Plans"],"prefix":"10.1177","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7439-0799","authenticated-orcid":false,"given":"Eric T.","family":"Roberts","sequence":"first","affiliation":[{"name":"University of Pennsylvania, Philadelphia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliza","family":"Macneal","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenton J.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Washington University in St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 F.","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health, Boston, MA, USA"},{"name":"Brigham and Women\u2019s Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,2]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Allen S. M. Piette E. R. Mor V. (2014). The adverse consequences of unmet need among older persons living in the community: Dual-eligible versus Medicare-only beneficiaries. The Journals of Gerontology: Series B 69(Suppl_1) S51\u2013S58. https:\/\/doi.org\/10.1093\/geronb\/gbu124","DOI":"10.1093\/geronb\/gbu124"},{"key":"e_1_3_3_3_1","unstructured":"Barnette L. P. (2021 June 15). CMS update on Medicare A\/B payments for New York FIDA-IDD MMP. Centers for Medicare and Medicaid Services. https:\/\/www.cms.gov\/files\/document\/cmsupdateoncy2021medicareabpaymentsforphp.pdf"},{"key":"e_1_3_3_4_1","unstructured":"Bella M. Hinckley J. Roberts E. Weil A. Weiner J. Werner R. M. (2024). Forging a path toward integrated care for dually eligible individuals. https:\/\/d197nivf0nbma8.cloudfront.net\/uploads\/2024\/11\/V3_Forging-a-Path-Toward-Integrated-Care-for-Dually-Eligible-Individuals_Final-for-Webv3.pdf"},{"key":"e_1_3_3_5_1","unstructured":"Bravo M. C. Roth J. Vilhuber L. (2024). Mcaceresb\/stata-honestdid. https:\/\/github.com\/mcaceresb\/stata-honestdid (Original work published 2022)"},{"key":"e_1_3_3_6_1","doi-asserted-by":"crossref","unstructured":"Bundorf M. K. McInerney M. Simon K. Winecoff R. (2024). Spillovers in public benefit enrollment: How does expanding public health insurance for working-age adults affect future health insurance choices? (Working paper no. 32675). National Bureau of Economic Research. https:\/\/doi.org\/10.3386\/w32675","DOI":"10.3386\/w32675"},{"key":"e_1_3_3_7_1","unstructured":"Burns A. Pe\u00f1a M. T. Mohamed M. Freed M. Watts M. O. (2024 October 22). What are the primary Medicaid eligibility pathways for dual-eligible individuals? KFF. https:\/\/www.kff.org\/medicaid\/issue-brief\/what-are-the-primary-medicaid-eligibility-pathways-for-dual-eligible-individuals\/"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2012.0197"},{"key":"e_1_3_3_9_1","unstructured":"Centers for Medicare and Medicaid Services. (n.d.-a). Financial alignment initiative for Medicare-Medicaid enrollees. CMS.gov. https:\/\/www.cms.gov\/priorities\/innovation\/innovation-models\/financial-alignment"},{"key":"e_1_3_3_10_1","unstructured":"Centers for Medicare and Medicaid Services. (2019 March 19). Joint rate setting process for the financial alignment initiative\u2019s capitated model. CMS. https:\/\/www.cms.gov\/files\/document\/capitatedmodelratesettingprocess03192019.pdf"},{"key":"e_1_3_3_11_1","unstructured":"Cornelio N. (2023). Eligibility and enrollment in Medicaid for low-income Medicare beneficiaries: The role of state policy [Unpublished doctoral dissertation]. University of Pittsburgh. https:\/\/d-scholarship.pitt.edu\/44025\/"},{"key":"e_1_3_3_12_1","unstructured":"Feng Z. Vadnais A. Vreeland E. Haber S. Wiener J. Baker B. (2019a May 8). Analysis of pathways to dual eligible status: Final report. Office of the Assistant Secretary for Planning and Evaluation. https:\/\/aspe.hhs.gov\/reports\/analysis-pathways-dual-eligible-status-final-report-0"},{"key":"e_1_3_3_13_1","unstructured":"Feng Z. Vadnais A. Vreeland E. Segelman M. Ferrell A. Wiener J. M. Baker B. (2019b May 8). Loss of Medicare-Medicaid dual eligible status: Frequency contributing factors and implications. 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(2017). Passive enrollment of dual-eligible beneficiaries into Medicare and Medicaid managed care has not met expectations. Health Affairs 36(5) 846\u2013854. https:\/\/doi.org\/10.1377\/hlthaff.2016.1082","DOI":"10.1377\/hlthaff.2016.1082"},{"key":"e_1_3_3_17_1","unstructured":"Greene A. (2017 March). Beneficiary experience: Early findings from focus groups with enrollees participating in the financial alignment initiative. Centers for Medicare and Medicaid Services. https:\/\/www.cms.gov\/medicare-medicaid-coordination\/medicare-and-medicaid-coordination\/medicare-medicaid-coordination-office\/financialalignmentinitiative\/downloads\/focusgroupissuebrief508032017.pdf"},{"key":"e_1_3_3_18_1","doi-asserted-by":"crossref","unstructured":"Johnston K. J. Roberts E. T. Figueroa J. F. (2024). Helping dual-eligible individuals navigate Medicare and Medicaid. 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