Understanding the Experiences of Dually Eligible Beneficiaries Enrolled in MI Health Link

Understanding the Experiences of Dually Eligible Beneficiaries Enrolled in MI Health Link

Report Summary
Published: Dec 30, 2022
Publisher: Mathematica
Associated Project

Research Regarding the Experience of Health Care and Other Services for Individuals Dually Eligible for Medicare and Medicaid

Time frame: 2021-2026

Prepared for:

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Medicare - Medicaid Coordination Office


Madelaine Spiering

Faye Miller

Key Findings
  • Care coordination: Most beneficiaries receiving HCBS and most beneficiaries in the MMC group reported positive relationships with thie care coordinators, while some in the BH group reported frustration with their care coordination or reported not receiving needed services. Several beneficiaries in all groups reported frustration with staff turnover.
  • Access: Most beneficiaries in all groups reported satisfaction with their access to services.
  • Challenges: A few beneficiaries with BH needs reported challenges accessing Durable Medical Equipment (DME). Beneficiaries in rural areas were more likely to report challenges with accessing medical specialists or Non-Emergency Medical Transportation (NEMT).
  • Impact of COVID -19: Most beneficiaries among all groups reported that they continued to receive their needed services without major disruption during the COVID-19 Public Health Emergency, and several reported that they began to use telehealth for medical appointments.

This brief describes the results of our research on beneficiaries’ experiences with care coordination and access to health care services, home- and community-based services (HCBS), and social services in the Medicare-Medicaid Financial Alignment Initiative (FAI) demonstration in Michigan, known as MI Health Link. The results of this research are based on our interviews conducted from April to June 2022 with Integrated Care Organization (ICO) enrollees who are dually eligible for full Medicare and Medicaid benefits.

Through our analysis, we observed important differences in care coordination experiences for each of the three higher-risk subgroups that we identified for recruitment purposes: 1. Individuals with multiple chronic conditions (the “MCC group”), 2. Individuals with BH conditions who may or may not have multiple chronic conditions (the “BH group”), and 3. Individuals receiving HCBS who may or may not have multiple chronic conditions (the “HCBS group”). Most participants in the MCC and HCBS groups reported a relationship with an ICO care coordinator, although beneficiaries in the BH group generally reported that they did not feel connected to their ICO care coordinator. Additionally, more beneficiaries in the BH and HCBS groups reported unmet social needs compared to those in the MCC group. Based on these observations, the study team developed fictitious user personas that summarize the experiences of each beneficiary subgroup. The report identified key findings based on the areas of care coordination, access, challenges, and impact of COVID-19.

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