www.chcs.org

The Value of Stakeholder Engagement for Integrated Care

Alliance for Health Care Reform Briefing December 12, 2011Suzanne S. GoreDirector, Integrated Care, CHCS

OverviewOverview

• Why stakeholder engagement is important

• Key stakeholder groups

• What methods of communication are available

• Lessons from states: Stakeholder priorities

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Why Stakeholder Engagement is Why Stakeholder Engagement is ImportantImportant

• Critical for a state to develop a program that truly meets the needs of dual eligible beneficiaries.

• Opportunity to share the state’s vision for improved care.

• Chance to learn from stakeholders how care can be improved and understand what is working.

Why Stakeholder Engagement is Why Stakeholder Engagement is ImportantImportant

• Allows states to develop a partnership with stakeholders

► Convey the message: “Your Input is Critical”► Include stakeholder’s recommendations or explain

when that is not possible

Integrated care will not move forward without stakeholder support.

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Why Stakeholder Engagement is Why Stakeholder Engagement is ImportantImportant

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Integrated care will not work with numerous carve outs and exclusions for certain services and populations.

Experience in Virginia:Began with this

Ended with this

Key Stakeholders Critical to Achieving Key Stakeholders Critical to Achieving Buy-in for Integrated CareBuy-in for Integrated Care

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Figure 2: Key Stakeholders Critical to Achieving Buy-in for Integrated Care Models

ProvidersandProvider Groups

Nursing facilities and nursing facility associations Hospitals and hospital associations Home health agencies and home health association Hospice/palliative care programs and hospice associations Personal care workers and their union representatives Nurses and their union or association representatives Medical providers and their local/state associations Mental health providers/clinics; BHOs Substance use disorder treatment providers Health plans, ACOs, other contracted entities DME, other specific contracted providers Transportation providers

Consumer and Advocacy Organizations

Beneficiaries and their family and friends AARP local/state representatives Educational/advocacy organizations for Medicare and other insurance (e.g.,

Senior Health Insurance Benefits Assistance program ) Legal services organizations Mental health advocates, e.g., National Alliance on Mental Illness

representatives Faith-based organizations Advocates for specific cultural and ethnic groups

Others Native American tribal representatives (which are sovereign nations and also

providers/contracted entities for certain health services)

Communication MethodsCommunication Methods

• Focus Groups

• Cross-Disciplinary Stakeholder Meetings

• Stakeholder Workgroups

• Public Webinars

• Project-Specific Websites

• Requests for Information

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Lessons from States: Stakeholder Lessons from States: Stakeholder PrioritiesPriorities

• Assistance in navigating the system► A single point of coordination for all Medicare and

Medicaid benefits and connected providers.

• Greater flexibility in service use through blended funding

• Access to the full continuum of services, including community-based care options

• Person- and family-centered approach to careCHCS’ work in California is illustrated by this report: M. Bella, A. Lind, and S.A. Somers. Options for Integrated Care for Duals in Medi-Cal:

Themes from Interviews with Key Informants and Community Dialogues. Center for Health Care Strategies, Inc., March 2010.

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ConclusionConclusion

• Numerous stakeholder groups will have countless priorities

• Remember why we are all working on integrated care- the guiding question is “Will this improve the care and the lives of beneficiaries?”

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