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Complex Care Opens the Lines for Consumer Voices

Twelve million people in the United States receive both Medicare and Medicaid benefits, yet only 10% are enrolled in plans to coordinate all of their care. To increase the reach of integrated Medicare-Medicaid models, Arnold Ventures is asking consumers and their advocates what matters most in integrated programs.

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In order to improve care and outcomes for the 12.2 million individuals dually eligible for Medicare and Medicaid, Arnold Ventures is interested in policies that better integrate care for those who must navigate these two separate public programs. The intention of these models is to offer a streamlined and coordinated care experience for dual-eligible individuals.

However, even when these models are available, people do not always select them. There are many reasons for this, including the fact that currently available integrated plans may not effectively meet consumers’ needs.

To better understand the experiences and perspectives of people who are dually eligible for Medicare and Medicaid, AV has made recent investments in several partners’ work, including:

  • Brief by ATI Advisory that details the protections available to consumers through integrated plan options
  • Brief by Community Catalyst that explores the experience of people who are dual-eligible when making health plan decisions and outlines strategies to increase enrollment into integrated plan options
  • Brief by IMPAQ International that uses a human-centered design (HCD) approach to understand the challenges and gaps that dual-eligible individuals encounter when seeking care.

To build on that foundation and expand the breadth and diversity of our partner community, we are issuing a request for information (RFI) to gather additional information from consumer advocates, thought leaders, and technical assistance providers. The input gathered will help inform future policy positions around care integration for the dual-eligible population.

RFI Process

Who should respond: Disability and elder care consumer advocacy organizations, both local and national, and thought leaders who represent dual-eligible consumers.

How to respond: Please submit your response to complexcare@arnoldventures.org.

Submission date: Please submit completed responses to complexcare@arnoldventures.org by Thursday Sept. 16.

Contact: For any questions about the RFI, please contact complexcare@arnoldventures.org.

Grants

Arnold Ventures funds projects to understand problems and identify policy solutions.

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