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CONCLUSION APPENDICES APPENDIX A: Policy Options for HHS and States to Enhance Medicare-Medicaid Integration in D-SNPs APPENDIX B: Subject Matter Experts, Case Study Interviewees, and State Officials APPENDIX C: Additional Policy Options LIST OF EXHIBITS EXHIBIT 1: Percentage of Dual Eligible Beneficiaries Enrolled in D-SNPs, 2017 EXHIBIT 2: Tennessee's Approach to Promoting Aligned D-SNP-MLTSS Plan Enrollment EXHIBIT 3: States with Aligned D-SNPs and MLTSS Programs, 2017 EXHIBIT 4: Minnesota Provides Input on D-SNP Provider Network Standards EXHIBIT 5: Massachusetts' Care Management Requirements Promote Continuity of Care EXHIBIT 6: Arizona Uses Marketing Tools to Encouraging Aligned Enrollment EXHIBIT 7: Massachusetts and Minnesota Use Integrated Materials to Improve Beneficiaries' Experience of Care EXHIBIT 8: Tennessee Requires Data Exchange to Promote Care Coordination EXHIBIT 9: Arizona and Tennessee Encourage Aligned Enrollment Through Seamless Conversion EXHIBIT 10: Criteria for FIDE SNP and Highly Integrated D-SNP Designations EXHIBIT 11: New Jersey Uses FIDE SNPs to Provide Integrated Care ACRONYMS The following acronyms are mentioned in this report and/or appendices

Increased Costs and Lack of Transparency One of the most significant issues with multiple MAC lists is the lack of transparency