Medicaid Managed Care - U.S. Senate Special Committee on Aging

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Initiatives under way may prove effective in facilitating consumer involvement.
For example, the Foundation for Accountability (FACCT), an organization primarily
of consumer and purchaser representatives, is seeking to develop new performance
measures for managed care that are patient centered. 15 Brandeis University has
developed a Consumer Access, Voice and Ownership (CAVO) survey.
Finally, mechanisms must be in place to assure that consumer input is used in
planning or modifying the program. Feedback loops create ways to make sure such
input is used.
Lessons
* Consumer involvement must be early and regular throughout
program development, operation and monitoring. Resources must be
invested to successfully obtain and use consumer input.
* Use multiple strategies to obtain consumer input. One mechanism
(such as a consumer satisfaction survey) may be of limited usefulness.
* Consumers do not speak with one voice. Issues are different for
different populations of consumers, family members, etc. Be sure
consumer engagement is culturally sensitive and that samples are
stratified.
* <strong>Medicaid</strong> programs should reach out to mental health programs for
input from consumers and nomination of consumers to participate on
advisory councils, etc.
* Complaints and grievances can not be overlooked as a source of
consumer input.
* Build in feedback routes to assure that consumer input is used in
planning or modifying the program.
Administrative Issues
States need significant time and resources to successfully implement managed
mental health care and to develop new relationships among state agencies, with
consumer groups, and with other stakeholders. Issues to be worked out include
claims processing, data and payment systems. Colorado spent three years in the
I5 Aice G. Gosfield, Who Is Holding Whom Accountable for Quality?," Health Affairsl 6, no.
3 (May/June 1997): 35.
The National Academy for State Health Policy * 0 8/97 Iv-97