Medicaid is the largest health care program in the United States and impacts the lives of more than 76 million Americans, nearly one-quarter of the nation’s population. The program can play a powerful role in influencing the health and well-being of individuals and families.
State Medicaid programs can only be truly successful, however, if they are responsive to the needs and priorities of the clients they serve—not providers, but patients and their families. Medicaid officials understand this. However, in the resource- and time-constrained environments in which Medicaid staff operate, finding the right avenues for gathering meaningful consumer input can be a challenge.
The Robert Wood Johnson Foundation has been trying to address these challenges through its work to transform health and health care systems. As part of these efforts, the Foundation along with the Center for Health Care Strategies recently engaged experts, including representatives from across the patient advocacy world, around this issue. These experts include leaders from Altarum, American Cancer Society Cancer Action Network, Community Catalyst, Georgetown Center for Children and Families, Nonprofit Finance Fund, and the Patient Advocate Foundation.
Here are some practical, insightful suggestions from these partners regarding how Medicaid can better engage patients in the policymaking and implementation process.
Some states are already refreshing their approaches to engaging patients in designing system transformation efforts. For example, Massachusetts Medicaid (MassHealth) developed the One Care Implementation Council to give consumers an active role in implementing the Financial Alignment Initiative in ways that truly reflect patient preferences. The One Care Council enabled consumers to go beyond serving in traditional advisory roles and instead become deeply involved as partners to the state in program implementation.
The Council, which was comprised of a diverse group of patients, family caregivers, community organizations, and providers, helped the state work through a range of implementation issues including enrollment processes, the effective use of assessment tools and care plans, care coordination strategies, and the use of peer supports. State partners attended council meetings, ensuring that decision-makers were at the table to hear patient experience and input and could incorporate feedback into state actions.
Tricia McGinnis, MPP, MPH, is senior vice president at the Center for Health Care Strategies. In this role, she oversees CHCS’ broad delivery system and payment reform portfolio, and directs the organization’s far-reaching communications efforts and unique Medicaid leadership and capacity-building programs.
Andrea Ducas, MPH, is a senior program officer with RWJF, working to help build a Culture of Health. Having joined the Foundation in 2012, she praises its “distinguished reputation in public health and healthcare, and its unique vantage point at the nexus of health policy development and program implementation.”
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