Meaningful Consumer Engagement: A Toolkit for Plans, Provider Groups and Communities

The Transformative Power of Consumer Engagement

The key to successful integrated care – especially for older adults and people with disabilities – is active, meaningful consumer engagement, since consumers and their caregivers are at the heart of everything we do.

— Dr. Robert J. MasterFormer CEO, Commonwealth Care Alliance

As state demonstrations to improve and integrate care for Medicare-Medicaid enrollees (also known as “dual eligibles”) move forward, health plans and provider groups (here, referred to collectively by the term “delivery systems”) must employ meaningful consumer engagement strategies. Federal guidance from the Centers for Medicare and Medicaid Services calls upon states to ensure the voices of older adults, persons with disabilities, and their caregivers are heard in the design, implementation, and oversight of the demonstrations. Their voices are vital because Medicare-Medicaid enrollees have complex medical and social needs, as well as personal preferences, that all members of the delivery system need to understand and respect in order to truly provide person-centered care. Community Catalyst believes that consumer engagement, done well, fosters an atmosphere of active, ongoing collaboration and conversation that will benefit consumers and their caregivers, health plans and provider groups, and ultimately transform the health care delivery system. To ensure meaningful consumer engagement occurs, Community Catalyst created a Toolkit for delivery systems to use as they implement effective strategies of engagement.

Engaged Consumers Have Many Seats At The Table

There are several ways that delivery systems can give consumers a seat at the table and increase the depth of their participation up the so-called “ladder of engagement.” From surveys and focus groups to member meetings, consumer advisory committees and governing board membership, delivery systems that diversify how they engage consumers will ultimately improve the way all consumers experience and participate in their own health care and in their newly integrated health care delivery system. Since family members and caregivers often play a critical role in a Medicare-Medicaid beneficiary’s health care and social well-being, they need to be welcomed to the table, as well. Using culturally and linguistically competent materials, providing oral interpreters and conducting meetings in languages spoken by the community and in locations accessible to consumers with disabilities will help reduce barriers to participation and allow diverse perspectives to be heard in multiple settings.

Engaged Delivery Systems Fine-tune Care Delivery

Meaningful feedback from consumers can help a delivery system fine-tune its care delivery by rethinking organizational priorities, addressing current problems and spearheading new initiatives. Examples might include, respectively: (1) developing a transition plan for members living in institutional settings, (2) improving cultural competence within communication materials, and (3) conducting a disability sensitivity training for providers. In several states’ Memoranda of Understanding (MOU), each participating delivery system is required to regularly convene a consumer advisory committee whose input must flow up to the governing board. For broad-based engagement to occur, delivery systems should pay special attention to addressing barriers to member participation in these committees, including a need for training about health policy issues and committee protocols. Delivery systems should also make sure the demographic make-up of the committee reflects the diversity of the enrollee population overall. Our consumer engagement checklist outlines how to assess committee composition, as well as incentives and barriers to participation. Delivery systems may also consider using an application and/or interview process to evaluate candidates for the advisory committee or when appointing consumers to their board of directors or other governance committee. Doing consumer engagement well, a delivery system will lower its costs, improve the health and quality of life of its consumers, attract new members, and position it well for potential Medicaid expansion or other new business when members share their positive experience in the community.

To sum it up, active, meaningful consumer engagement gives delivery systems and their consumers the tool they need the most to improve and maintain health and quality of life – information that leads to action. Delivery systems need information from consumers and their caregivers about the stronger and weaker aspects of care delivery – aspects that impact the system’s bottom line as well as consumers’ health outcomes and quality of life. Similarly, consumers and their caregivers need easy-to-understand information about how to best navigate their newly integrated delivery system and how the system is using consumer feedback for continued quality improvement. This “feedback loop” between consumers, their caregivers, and the entire health care delivery system will be critical to the success of the demonstrations.

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In the toolkit:

Meaningful Consumer Engagement: A Toolkit for Plans, Provider Groups and Communities was written and produced by Community Catalyst, led by William Dean and with the assistance of Courtney Mulroy, Rosa Palacios and John Ruiz of Commonwealth Care Alliance. Additional contributions to the development of this toolkit came from Ken Pariseau and Jacqueline Dowdy of Neighborhood Health Plan of Rhode Island, and Ben Juaregui of Inland Empire Health Plan. Special thanks go to Mary Kennedy of the Association of Community Affiliated Plans for her guidance. Meaningful Consumer Engagement: A Toolkit for Plans, Provider Groups and Communities was developed as part of Voices for Better Health with the generous support of The Atlantic Philanthropies.

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