Key Findings From the Medicaid MCO Learning Hub Discussion Group Series and Roundtable — Focus on Member Engagement and the Consumer Voice

Brief/Report
January 2021
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Headline

Representatives from Medicaid managed care organizations (MCOs) offer recommendations for effective member and community engagement activities, including providing greater touchpoints for members and families through the care journey and facilitating shared community decision-making through community advisory committees (CACs).

Context

Effective community engagement can guide quality improvement and organizational changes that are more responsive to patient needs and can help bridge gaps in trust between health care organizations and historically marginalized communities. Medicaid MCOs often play a pivotal role in these efforts, engaging directly with members and conducting broader community engagement initiatives, including CACs.

This report draws upon interviews and a roundtable discussion with MCO representatives to identify common approaches, challenges, and promising practices in facilitating effective community engagement.

Findings            

MCO representatives highlighted two distinct levels of engagement: (1) initiatives targeting members and their families to enhance care delivery and improve patient outcomes; and (2) broader community-focused endeavors aimed at developing programs and policies to improve community health. Key facilitators of effective community engagement identified by MCO representatives include initial enrollment welcome calls, in-person engagement, and partnerships with community-based organizations (CBOs). Gaps in member contact information and demographic data, other administrative challenges, spoken language, lack of cultural competency and diversity among MCO staff, and social needs were identified as barriers to effective community engagement.

MCO representatives underscored the importance of CACs in promoting deeper levels of community engagement. CAC implementation recommendations highlighted in the report include financial incentives for participation, accessible meeting times and locations, feedback mechanisms, and CBO partnerships.

Takeaways

This report provides comprehensive and actionable guidance for Medicaid MCOs seeking to improve community engagement efforts. It highlights a wide array of community and direct member engagement activities, each with its own unique implementation barriers and key strategies. These activities hold the potential to advance a range of priorities for MCOs and state Medicaid agencies, including improved health outcomes, more effective allocation of community health resources, and improved trust between health care organizations and historically marginalized communities.

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