In 2019, 48 percent of Medicare-Medicaid dual-eligible beneficiaries identified as being from a racially/ethnically minoritized group, while only 21.6 percent of Medicare-only beneficiaries were from racially/ethnically minoritized groups. Since 2006 the percent of dual-eligible beneficiaries from racially/ethnically minoritized groups has grown by 19.2 percent, and we can expect this growth to continue as our population ages and diversifies. Dual-eligible beneficiaries are also more likely than non-dual-eligible beneficiaries to experience adverse health outcomes.
The link among dual eligibility, race, and adverse health outcomes is not coincidental. Researchers have noted that racism is a fundamental cause of the socioeconomic inequalities that exist by race. Racism and discrimination over the life course also have a weathering effecton the body and lead to poorer health outcomes. To meet the needs of this diverse and high-risk dual-eligible population, experts agree that there needs to be increased access to integrated care programs. The Medicaid and CHIP Payment and Access Commission (MACPAC) even recommended that states be required to develop and implement integrated strategies. Despite how important this is and the specific call for these strategies to promote health equity, we argue that advancing health equity through integrated care programs will require for these programs to be culturally appropriate.