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Mathematica researchers conducted a study to determine what factors were associated with state variation in participation rates in the Centers for Medicare and Medicaid Services’ Financial Alignment Initiative (FAI) that offered beneficiaries eligible for both Medicare and Medicaid enrollment in integrated Medicare– Medicaid plans (MMPs). The researchers found three major factors were associated with higher enrollment: (1) use of passive enrollment, in which states automatically enroll eligible beneficiaries into an MMP; (2) alignment of key features of the FAI demonstration with the existing state Medicaid managed long-term services and supports (MLTSS) program; and (3) beneficiaries’ relationships with care coordinators. This brief looks closely at the first two factors: passive enrollment and demonstration/MLTSS alignment.