Tips for States Using Enrollment Brokers in the Capitated Financial Alignment Demonstrations: Beneficiary FAQs and Suggested Responses

Tips for States Using Enrollment Brokers in the Capitated Financial Alignment Demonstrations: Beneficiary FAQs and Suggested Responses

ICRC Technical Assistance Tool Brief
Published: Apr 30, 2017
Publisher: Washington, DC: Integrated Care Resource Center
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Authors

Julie Stone

Claire Postman

States that run capitated demonstrations under the Centers for Medicare & Medicaid Services’ (CMS) Financial Alignment Initiative often contract with enrollment brokers to answer calls from beneficiaries about the demonstrations. Enrollment brokers use customer service representatives (CSRs), who are often callers’ primary source of information about key features of the demonstrations. For example, CSRs may answer questions about services covered by Medicare-Medicaid plans (MMPs), enrollment and disenrollment dates and options, and the continuity-of-care process. Because of CSRs’ critical role in informing beneficiaries about their enrollment choices, states should work closely with their enrollment brokers to ensure that CSRs are using clear and accurate language to explain the complex features of the demonstrations.

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