The Centers for Medicare & Medicaid Services (CMS) appears to be overly optimistic about saving money by integrating benefits for disabled people under 65 years who are eligible for both programs, according to the Government Accountability Office (GAO).
Congress and CMS have emphasized the need to integrate benefits for disabled and aged dual-eligible beneficiaries, which is expected to reduce spending and improve care.
Medicaid accounted for nearly two-thirds of spending for high-expenditure, dual-eligible individuals (http://1.usa.gov/1yHPpO6). Based on claims data from 2009, Medicare and Medicaid spent an estimated $103 billion on disabled dual-eligible beneficiaries. States with high Medicaid spending often had lower Medicare spending but nearly always spent more in total on the disabled dual-eligible beneficiaries.
Rubin R. Integrating Care for Younger Disabled Does Not Improve Spending. JAMA. 2014;312(18):1850. doi:10.1001/jama.2014.15167