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As a result, as a person begins to lose weight, they will start to notice excess skin hanging from their arms, legs, stomach, and other parts of their body

In addition, states have several program design options that can increase the degree of Medicare-Medicaid integration and alignment in their DSNP-based programs, including from least to most aligned (Archibald & Kruse, 2015): Include Medicare Cost-Sharing, Medicaid Wraparound Services, or Both : States can require DSNPs to pay enrollees' Medicare premiums and cost-sharing out of their capitation payments (state Medicaid agencies would otherwise pay for premiums or cost-sharing directly), which can help to coordinate claims processing, reduce administrative burden on providers, and decrease instances of balance billing of enrollees

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