“[M]y biggest issue again goes back to just how complicated all of this is for a group of people that probably are not well-equipped to navigate it. It frustrates me that it couldn’t be a little bit simpler.”
—Enrollment Assister


FOR IMMEDIATE RELEASE

July 21, 2023
Contact: Jack Cardinal, (781) 960-5208, jcardinal@communitycatalyst.org

(BOSTON, MA) — People dually eligible for Medicare and Medicaid face overwhelming enrollment decisions that significantly impact their health outcomes. Not only do they face an increasingly complex, integrated care enrollment landscape, they have limited trusted resources to turn to for assistance.

In response, the Center for Community Engagement in Health Innovation at Community Catalyst (the Center) unveiled new research and recommendations informed by listening sessions with both people with lived experience as well as deep policy expertise to help the federal government create a better system that responds to the needs and preferences of the community it serves.

“In many ways, the current system is not working for people,” said Dr. Brandon G. Wilson, senior director of the Center for Community Engagement in Health Innovation at Community Catalyst. “We have heard from dually eligible people about the challenges of navigating through two complicated health care systems and feeling lost in a maze of multiple doctors, medications and programs. The care system will not work well until it responds to the people who are furthest from their ideal health because of longstanding, systemic barriers to care.”

The report, “Policy Options to Create a Person-Centered Enrollment Infrastructure for Medicare-Medicaid Enrollees,” outlines the need for a federal resource hub and robust training network to support community-based and direct service-organizations supporting people who are dual eligible. It also proposes several, concrete actions The Centers for Medicare and Medicaid Services (CMS) and other entities could take to make both initiatives a reality.

The report is based on comprehensive data collected through listening sessions with enrollment and education assisters and dually eligible individuals; in-depth federal and state-level interviews to gain valuable insights into the outreach, education, and enrollment landscape; and a federal policy analysis. The findings reveal the failings of the current system in meeting peoples’ diverse needs and preferences.

The findings and recommendations aim to drive meaningful change by fostering improved access to quality care and ensuring individuals receive the comprehensive support and services they rightfully deserve. The Center will now work on dissemination of the findings and working with dual eligible people and key stakeholders to bring this vision of a person-centered enrollment system to life.

The report features direct feedback from enrollees and the people who support them describing the barriers in their own words. One assistor noted, “[M]y biggest issue again goes back to just how complicated all of this is for a group of people that probably are not well-equipped to navigate it. It frustrates me that it couldn’t be a little bit simpler.”

It also features the story of Holly, a Boise, ID resident who describes how life changing finally getting access to both Medicare and Medicaid was for her health and independence, as well as the 19 years of frustration trying to get to that point. “Knowing that I have a clean house, knowing that I have some meals prepped – those have helped a lot. I believe I have been blessed to have Medicaid with the Medicare now.”

This work is part of Community Catalyst’s effort to lead health system transformation by building a system that adopts community-led and people-centered health innovation models as well as pushes for health care workforce innovations that are diverse and embrace the role that communities have played for decades in creating workforce solutions.


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About Community Catalyst:

Community Catalyst is a leading non-profit national health advocacy organization dedicated to advancing a movement for race equity and health justice. We partner with local, state and national advocates to leverage and build power so all people can influence decisions that affect their health. Health systems will not be accountable to people without a fully engaged and organized community voice. That’s why we work every day to ensure people’s interests are represented wherever important decisions about health and health care are made: in communities, state houses and on Capitol Hill. For more information, visit http://www.communitycatalyst.org. Follow us on Twitter @CommCatHealth