Headline

Strategies for health plans conducting outreach to dually eligible individuals to better support health risk assessments and serve member needs.

Context

Health plans serving members eligible for both Medicare and Medicaid oftentimes find it hard to track and engage members due to out-of-date contact information. Not being able to contact members has a range of negative consequences, such as challenges in completing health risk assessments and ensuring continuous enrollment.

Findings

Resources for Integrated Care convened a focus group that included representatives from health plans in California, Massachusetts, Ohio, and Virginia with experience in serving dually eligible individuals. Based on findings from the focus group, this brief outlines considerations for health plans seeking to better locate members, including to: (1) hire staff from the community to conduct outreach and navigation; (2) ensure outreach staff have adequate training; (3) outline a set of best practices when conducting telephone outreach; (4) identify effective guidelines for in-person engagement with members; (5) coordinate and collaborate with providers, local agencies, community-based organizations, and informal social networks; and (6) contract with vendors to provide additional outreach and engagement. In addition, this brief emphasized the importance of designating a point of contact for each member, and taking steps to solicit feedback from members and encourage member engagement.

Takeaways

Health plans serving dually eligible individuals can use this brief when developing strategies to better locate and engage their members, including to hire and train staff from the community to lead this outreach.