Online Program

Early Experiences of Dual-Eligible Enrollees in the Massachusetts Integrated Care Demonstration: Findings from the One Care Member Experience Survey

Tuesday, November 3, 2015 : 2:30 p.m. - 2:50 p.m.

Alexis Henry, ScD, OTR/L, Disability, Health and Employment Policy Unit, Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA
Michele Goody, MassHealth, Boston, MA
Dorothee Alsentzer, MassHealth, Boston, MA
Wendy Trafton, MPH, Center for Health Law and Economics, University of Massachusetts Medical School, Charlestown, MA
John Gettens, PhD, Disability, Health and Employment Policy Unit, Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA
Massachusetts was the first state to implement a demonstration to integrate care and align financing for individuals who are dually-eligible for Medicare and Medicaid.  The demonstration – known as One Care – is available to dually-eligible individuals, ages 21-64, living in nine Massachusetts counties.  Offered by three health care plans, One Care provides integrated primary, specialty, and behavioral health care, prescription medications, and community-based long-term services and supports (LTSS), using a person-centered approach.  Enrollment began in October 2013 with a period of voluntary enrollment, followed by waves of passive enrollment which continued through July 2014.  Individuals may opt-out of One Care at any time.  As of January 2015, over 17,800 individuals were enrolled in One Care. 

We present findings from the 2014 One Care Member Experience Survey (n=1,933), which examined enrollees’ early experiences in One Care across multiple domains: the enrollment process; assessment and care planning processes; interactions with care team, including primary care providers, care coordinators and LTSS coordinators; the extent to which care needs are being met; and satisfaction with and intention to stay in One Care.   Overall satisfaction with One Care appears high, with 83% of enrollees intending to stay in One Care.  Reported rates of unmet needs for medical care, behavioral health care, and prescription medications were low.  However, enrollees reported somewhat higher rates of unmet need for dental care and for community-based LTSS.  We discuss how survey findings are being used by policymakers to inform needed course corrections in the ongoing implementation of the demonstration.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Public health or related public policy

Learning Objectives:
Describe the Massachusetts demonstration to integrate care for dual-eligible individuals Discuss findings from a survey examining the early experiences of individuals enrolled in the demonstration Identify how Massachusetts policymakers use these findings to monitor and course correct in the ongoing implementation of the demonstration

Keyword(s): Disabilities, Health Care Delivery

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of multiple studies examining the health care experiences and unmet health care needs of working-age persons with disabilities. I currently lead the team examining the early experiences of working-age dual-eligible individuals enrolled in the Massachusetts integrated care demonstration.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.