Understanding the Information and Transparency Needs of Medicaid Managed Care Enrollees
Empowering Health Care Consumers
June 20, 2017
WebsiteSEE GRANT OUTCOMES
One-quarter of New York State’s population, more than 6.2 million people, relies on Medicaid for health insurance coverage. Most of these individuals are enrolled in Medicaid managed care organizations (MCOs), which contract with the State to assume responsibility for Medicaid enrollees’ health care.
For people enrolled in Medicaid with fewer resources, accessing information to maintain their health can be challenging. Transparency initiatives are of great value for enabling more informed and activated patients, but they may leave behind the millions of New Yorkers who rely on Medicaid. For example, transparency tools on quality variation among providers could be of value to this population, but it is unclear whether enrollees have access to or are aware of these tools. In 2017, NYHealth awarded Medicaid Matters New York (MMNY), through fiscal sponsor Schuyler Center for Analysis and Advocacy, a grant to understand the informational needs Medicaid enrollees.
Under this grant, MMNY gathered baseline data on the information and transparency needs of Medicaid managed care enrollees; the challenges enrollees face when trying to secure the tools and information needed; and if or how MCOs are taking steps to meet those needs. MMNY oversaw focus groups across the State to ensure that the full diversity of Medicaid enrollees were represented, including geographic and regional variation and urban and rural differences. MMNY then conducted complementary focus groups with MCOs to get their reaction to the identified information and transparency needs of enrollees, understand the ways in which MCOs were meeting these needs, and identify gaps that might exist. MMNY prepared a final report outlining the findings from the focus groups and recommendations for improving Medicaid enrollees’ access to information and resources.