Medicare and Medicaid have long served as foundations for expanding health coverage and access to health care while supporting those who need it the most: low-income children, seniors and people with disabilities. There are more than 10 million people enrolled in both Medicaid and Medicare ("dual eligibles") who make up a small, yet highly vulnerable, subset of these populations.

Dual eligibles are more likely to be in poor health, have higher levels of health impairments and make greater use of medical and support services, which makes them a challenging population to serve. Far too often, they are unnecessarily admitted into hospitals or placed in nursing homes. The price tag for the poor, uncoordinated care dual eligibles receive is massive and threatens the viability of our public programs, particularly at a time when state and federal budgets are already under great strain.

The Integrated Care Advocacy Project works to improve the lives of dual eligibles-particularly those of low-income older adults-while at the same time reducing the cost to public programs. Prompted by provisions in the Affordable Care Act, fast-moving efforts are now afoot in many states to change how services are provided to dual eligibles. The goal is to vastly improve services and care coordination for dually eligible individuals which will provide better care and curb escalating health care costs.

Community Catalyst has a long history of advocating to improve how care is delivered to dual eligible individuals. We help build expertise among beneficiaries and their advocates working with them to shape new reform initiatives so they best serve the needs of dual eligible. Our work includes:

• Providing tools and strategies on essential issues related to the development of integrated systems of care for dual eligibles
• Promoting best practices from innovative plans and providers that serve dual eligibles
• Fostering collaboration among advocates, plans, providers and policymakers
• Building an ongoing and meaningful role for consumers and advocates in the implementation of new dual eligible initiatives.

As part of our work to educate and engage consumers, Community Catalyst developed a dynamic and interactive advocacy training program Lift Up Your Voice! to educate people about the health care system. Aimed at older adults with chronic conditions and their caretakers, it demonstrates how individuals play and integral role in shaping health policy, teaches them advocacy strategies, and introduces them to state and local opportunities for influencing policymakers. The Trainer's Toolkit is a resource for guiding new trainers to lead successful advocacy training programs to engage and motivate participants to get involved in a local or state campaign for better care at lower costs.