How Consumer Perspective Helped Direct a New Health Care Program

Erin McGaffigan

Erin McGaffigan

The One Care Implementation Council was established in Massachusetts five years ago to engage consumers and their advocates in the design and oversight of a new health care program serving people with disabilities who are eligible for both Medicare and Medicaid.

So how did that work out?

The LeadingAge LTSS Center @UMass Boston, with the Center for Consumer Engagement in Health Innovation, recently released a new case study that examines the creation and development of the council in detail.

“The council provides a powerful example of effective engagement by consumers and their advocates,” said Erin McGaffigan, a co-author of the case study and a LTSS Center fellow. “It also provides lessons for consumer engagement that have relevance for advocates, public officials and health plan leaders.”

The One Care program was launched in 2013 to serve dual-eligible adults with disabilities who are 21 to 64 years of age at the time of enrollment. Massachusetts is one of 13 states with such a dual demonstration program, part of a national effort led by the Centers for Medicare and Medicaid Services’ Medicare-Medicaid Coordination Office to improve care for dual-eligible individuals.

The Massachusetts program now serves over 19,000 people through integrated healthcare, behavioral health and long-term services and supports (LTSS).

The One Care Implementation Council was established to ensure that stakeholders informed the implementation of the health care program. The council represents diverse stakeholder perspectives, with the majority of representatives being Medicaid members with disabilities, their family members, and guardians. The council also includes representatives from community-based organizations, advocacy organizations, unions, and providers.

The case study conducted by the LTSS Center and Center for Consumer Engagement examined the council’s formation and management in detail. It described the skills and characteristics of members, the areas in which they chose to focus their efforts and the impact they had.

Some of the key lessons identified in the case study include:

  • Membership and structures should be formed in partnership with community leaders and be flexible enough to grow and change over time.
  • Training and communication strategies should be multi-faceted and flexible.
  • Meaningful engagement requires you to “go where the people live, work and play.”
  • People with lived experience should be compensated for the time they invest.
  • Transparency and building of trust over time can lead to improved communication and effective decision-making among members and with state officials.

Co-author Danielle Skenadore Foster said the case study provides insights into how similar councils can assume a meaningful role in the design and improvement of dual demonstrations.

“The lessons learned in this study can inform future council improvements as well as the design of similar bodies across the nation,” she said.

One thought on “How Consumer Perspective Helped Direct a New Health Care Program

  1. This sounds intriguing. Is there a fuller report that I can share with fellow members of a coalition here in Richmond, VA, called the Area Planning and Services Committee (APSC) on Aging with Lifelong Disabilities?

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