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Renee Markus Hodin, JD Director, Integrated Care Advocacy Project

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Presentation on theme: "Renee Markus Hodin, JD Director, Integrated Care Advocacy Project"— Presentation transcript:

1 A Seat at the Table: Consumer Engagement in the Dual Eligible Demonstration Projects
Renee Markus Hodin, JD Director, Integrated Care Advocacy Project May 2, 2013 2013 American Geriatrics Society Annual Scientific Meeting Grapevine, Texas

2 About Community Catalyst
Nonprofit health care advocacy organization Network of advocates in 40+ states Building advocacy infrastructure Leading broad-based issue campaigns © 2013

3 Consumer Engagement: Design The Impact
The Demand Consumer Engagement: Design The Impact Consumer Engagement: Implementation © 2013

4 The Demand © 2013

5 Expectation of Consumer Involvement
“Medicare-Medicaid enrollees, their families and consumer organizations working with them… have a central role to play in helping to design a person-centered system of care….CMS encourages and expects active and meaningful State engagement with stakeholders in both models.” ~ State Medicaid Director letter on Financial Alignment Initiative July 11, 2011 © 2013

6 Expectation of Consumer Involvement
“Collaboration with consumer and consumer advocacy groups is critical. In order to achieve the important goals of better health and better care with lowered costs, we must continue to put our beneficiaries first. This is a time of significant change in the Medicaid program, and we should ensure beneficiaries’ voices are heard in the design, implementation, and oversight of new initiatives.” ~ State Medicaid Director letter on Integrated Care Models July 10, 2012 © 2013

7 The Key © 2013

8 Consumer Engagement: Design © 2013

9 Consumer Priorities Enrollment Beneficiary Protections
Provider Networks Long-Term Services and Supports Coordination Benefits Consumer Engagement Beneficiary Protections Adequacy of Payment/Savings Expectations Quality Measurement Cultural Competence © 2013

10 Coalition Aging Cross-disability Physical Behavioral health
Substance use disorder Legal services Medicaid defense © 2013

11 Grassroots Open meetings/educational sessions Individual stories
Hearing testimony Meetings with policymakers © 2013

12 Policy Analysis Hearing testimony Formal comments State Federal © 2013

13 Communications © 2013

14 Allies Geriatric providers LTSS providers AAAs Health plans
Medical homes © 2013

15 Policymakers Hearing testimony Formal comments State Federal
Workgroups Advisory teams © 2013

16 The Impact © 2013

17 Impact Size, scope, timing Reductions in population size
Shift from statewide to regional Delay in start-up date © 2013

18 Impact Enrollment Benefits No Medicare lock-in Vision Dental
Voluntary enrollment period Enrollment counseling Benefits Vision Dental Non-emergency transportation Behavioral health diversionary services © 2013

19 Impact Care Coordination Oversight
Contracts with LTSS referral/service providers IL-LTSS Coordinator Oversight State-level oversight committee Delivery system committees Ombudsman © 2013

20 Impact Consumer Protections Continuity of care Grievances and appeals
Aid pending appeal Improved notices Cultural Competence Increased emphasis on provider and staff compliance with the ADA Training requirements for independent living and recovering learning philosophies © 2013

21 Consumer Engagement: Implementation
© 2013

22 Consumer Priorities Enrollment Beneficiary Protections
Provider Networks Long-Term Services and Supports Coordination Benefits Consumer Engagement Beneficiary Protections Adequacy of Payment/Savings Expectations Quality Measurement Cultural Competence © 2013

23 The Key © 2013

24 Consumers Geriatric Providers
Collaboration Union of Policy and Practice Consumers Geriatric Providers © 2013

25 Collaboration Inform/participate in advocacy efforts
Convey views to larger public Advance evidence-based models of care Depression screening and treatment Transitions Self-management programs Promote the use of appropriate quality measures Oversight Promote role for geriatric providers © 2013

26 Voices for Better Health
Advance policies that require coordinated, patient-centered care that allows dually eligible older adults to have a better quality of life Establish a strong voice for dually eligible older adults and caregivers in the health plans and provider groups that serve them © 2013

27 Director, Integrated Care Advocacy Project
Renee Markus Hodin, JD Director, Integrated Care Advocacy Project Community Catalyst © 2013

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