The Dual Eligible Terms and Experience Study
Findings from User Testing and Formative Research in Minnesota and Arizona
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Associated Project
Research Regarding the Experience of Health Care and Other Services for Individuals Dually Eligible for Medicare and Medicaid
Prepared for:
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Medicare - Medicaid Coordination Office
Key Findings
- Most aligned enrollees had positive experiences with having one company manage their health care and found it easier to navigate.
- Most enrollees said they selected a plan based on information they received from family and friends, case managers/social workers, or from plan outreach. Enrollees did not pick plans based on the availability of additional benefits because most were unaware of those benefits before selecting a plan.
- Enrollees were generally unfamiliar with the terms “D-SNP” and “integrated care.” Enrollees liked language that described integration in the descriptions of D-SNP and integrated care. Most enrollees appreciated person-centered language.
- Enrollees had varied awareness of having a care coordinator through their D-SNP. The care coordinator/case manager term and descriptions felt unclear or misleading to some enrollees.
- In general, enrollees who speak Spanish tended to be less familiar with the terms that we tested than English speakers.
- Formatting makes a difference in how enrollees perceive information.
This report summarizes the research and findings from the Dual Eligible Terms and Experience Study that Mathematica led from October 2022 to April 2024 on behalf of the Medicare-Medicaid Coordination Office of the Centers for Medicare & Medicaid Services (CMS). The goals of the research study were to: 1) identify terms that resonate with dual eligible special needs plan (D-SNP) enrollees1 to improve communication and enrollee materials; and 2) understand D-SNP enrollees’ experiences with care coordination and plan selection. To address these goals, Mathematica conducted user testing and formative research interviews with D-SNP enrollees and State Health Insurance Assistance Program (SHIP) counselors from Minnesota and Arizona. To bolster inclusiveness and promote health equity, we prioritized including a diverse range of voices in the study.
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