This project studied the delivery of Medicare and Medicaid-funded services to dually eligible beneficiaries aged 65 and older in Minnesota. It compared fully-integrated managed care to service delivery when Medicare and Medicaid-funded services are delivered independently. The fully integrated Medicare-Medicaid managed care plans had greater primary care physician use and lower inpatient hospital and emergency department use. Similarly, home and community-based services use was greater and nursing home use was no greater. Once enrolled in the fully integrated plan, nearly all beneficiaries chose to remain, rather than switch to the alternative. In Minnesota, the fully integrated plan appears to be an improvement over the fragmented delivery systems of separate Medicare and Medicaid programs, yielding improved consumer satisfaction and service use.