Headline

Person-centered integrated care models designed to respond to the priorities of people dually eligible for Medicare and Medicaid are more likely to increase and sustain enrollment.

Context

Integrated care models for adults eligible for both Medicare and Medicaid aim to improve health outcomes while reducing overall health care costs. Low enrollment in these programs, however, means that many Medicare-Medicaid enrollees are not receiving these benefits. This report, published by the Center for Consumer Engagement in Health Innovations, details research on the causes for low enrollment in integrated care models. Focus groups and interviews were conducted in California, Illinois, Massachusetts, and Ohio to identify key features that influence enrollment.

Findings

This report identified four main priorities for dually eligible individuals that influence their decision to enroll in integrated care: (1) ability to continue seeing their current providers; (2) access to information to make an informed decision; (3) opportunity to seek guidance from a person they trust; and (4) potential to receive a benefit they could not get under current coverage. Enrollment strategies that address all four priorities, like improving the information beneficiaries receive and allowing them to maintain access to their providers, have the highest probability to succeed in increasing enrollment in integrated care models.

Takeaways

Policymakers and payers can use the recommendations in this report, which address the priorities of dually eligible individuals, to design person-centered enrollment models that will support higher participation in integrated care programs.