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

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.