Health Affairs August 10, 2023
Beneficiary engagement has been a federal statutory requirement in Medicaid since 1971 with varying degrees of effectiveness, but beneficiary engagement in Medicare is still new, relatively speaking. The Centers for Medicare and Medicaid Services (CMS) took a significant step in advancing engagement of dually eligible beneficiaries in Medicare and Medicaid when it required that Dual Eligible Special Needs Plans (D-SNPs) establish and maintain enrollee advisory committees (EACs) in January 2023.
Given states’ experience with beneficiary engagement in Medicaid and demonstrations under the Financial Alignment Initiative (FAI), examples of designing effective EACs already exist. EACs are described in the Calendar Year 2023 Medicare Advantage and Part D proposed rule, however, as an initial step in “enrollee participation in plan governance.” This...
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