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IMPAQ to Explore the Challenges of Integrating Care for Dual Medicare/Medicaid Beneficiaries Using Human-Centered Design

Columbia, Maryland

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August 11, 2020

IMPAQ was recently awarded a grant from Arnold Ventures to study the care integration challenges of individuals who receive both Medicare and Medicaid benefits, often referred to as “dual eligibles.” Arnold Ventures is a philanthropic organization with the mission to invest in evidence-based solutions that maximize opportunity and minimize injustice.

Approximately 9 million Americans are dually eligible for both Medicare and Medicaid. Dual-eligible beneficiaries are more likely than other Medicare beneficiaries to experience multiple chronic conditions, functional limitations or disabilities, or a serious mental illness or substance use disorder. The practice of integrating care (coordinating care among different providers in an organized way that meets a person’s needs) presents unique challenges for these individuals due to their complex care needs and the associated high costs. Although dual eligibles are especially likely to benefit from coordinated care, the current delivery of services across these programs continues to be fragmented.

Through this project, IMPAQ experts will use a human-centered design approach to uncover insights on care integration by describing how these individuals navigate the two different health care programs. Human-centered design (HCD) is an approach to problem solving that seeks to involve end-users in all phases of an iterative process of problem defining and solving. IMPAQ selected the HCD approach because it provides a framework and set of tools for navigating complex, dynamic, and ill-defined challenges.

“We are thrilled to have the support of Arnold Ventures in funding this project, which takes an innovative approach to understanding care integration in this vulnerable population,” says Project Director and IMPAQ Health Principal Researcher Melissa Hafner. “We hope that this work will shed light on the lived experiences of dual eligible beneficiaries and that we can provide a foundation for future solutions that improve their quality of life and health outcomes.”

This project is a new and unique addition to IMPAQ’s portfolio of Medicaid-related work, which also includes an evaluation of Washington, DC’s 1115 substance use waiver and an environmental scan of buprenorphine prescribing for the Medicaid and CHIP Payment and Access Commission.