Health plans serving individuals dually eligible for Medicare and Medicaid need to effectively engage their members in order to support individuals’ diverse needs via integrated care. Building trusting relationships with plan members requires significant effort. This is particularly the case for individuals experiencing mental health and substance use disorders, unstable housing/chronic homelessness, and language/literacy barriers – challenges that are frequently present among Medicare-Medicaid beneficiaries under age 65.
This brief outlines promising strategies for engaging Medicare-Medicaid enrollees with complex medical, behavioral health, and social service needs. The approaches outlined were gathered from organizations participating in CHCS’ PRIDE initiative, which focused on advancing health plan strategies for providing high-quality, cost-effective care for high-need populations eligible for Medicare and Medicaid.