Medicare Rights Center

Dual eligibles—individuals who qualify both for Medicare and Medicaid—account for 15% of New York State’s Medicaid enrollees, but represent 45% of total State Medicaid expenditures.

Dual eligibles often require a complex array of services from multiple providers, which results in fragmented and uncoordinated health care delivery. Starting in January 2015, the Federally Integrated Dual Advantage program (FIDA) has provided a new opportunity to coordinate care for this costly and complex population. Under FIDA, participating health insurance plans will be paid on a capitated basis to provide a comprehensive package of services that covers physical and behavioral health care; long-term care supports and services; and prescription medications. Although health care providers are uniquely positioned to encourage participation in the new model, many may not be fully aware that they are a FIDA provider. NYHealth awarded Medicare Rights Center (MRC) a grant to develop, test, and disseminate a FIDA toolkit and lead Web-based trainings for New York State providers.

Under this grant, MRC produced a comprehensive, user-friendly FIDA provider toolkit consisting of slide decks, FAQs, and English- and Spanish-language handouts for use by FIDA providers and their patients; conducted 8–12 webinar trainings for providers; convened a FIDA provider roundtable; and compiled and disseminated lessons learned and promising practices related to provider education to share in New York and nationally. MRC worked in partnership with providers to develop the educational content, helped lead presentations and field audience questions, and alerted colleagues and networks about these FIDA learning opportunities. To evaluate its impact following FIDA implementation, MRC surveyed providers who participated in the webinars. MRC also used the survey to gauge changes in provider knowledge, behavior, and ability to help patients within the FIDA program.