In Texas, about 400,000 people are on both Medicare and Medicaid. Right now, they’re on separate health plans: the state handles Medicaid, while the federal government oversees Medicare. But a pilot effort is underway to shed some redundancy and unnecessary cost – by folding the plans into one. Combining services under one plan would help people get the care they need in an appropriate facility – a nursing home instead of a hospital, for example, according to the Texas Health and Human Services Commission . Spokesperson Stephanie Goodman says it increases cost-saving incentives if one plan is not making decisions that are paid for by the other plan. "By combining it, you can get people better care in the right setting, lower costs generally, and the savings can be shared by both the state and federal government," Goodman says.