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People on both Medicaid and Medicare struggle navigating both services.
More than 15 million people are expected to be dual eligible by 2028.
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A new survey details the day-to-day health needs of dual-eligible beneficiaries.
Cityblock Health worked in partnership with Ipsos to survey 280 individuals who are enrolled in both Medicare and Medicaid.1 According to the healthcare provider, more than 15 million people are expected to be dual-eligible by 2028. People using both services at the same time report confusion and gaps in care.
The survey showed that:
In a press release, Cityblock Health CEO and co-founder Dr. Toyin Ajayi said, “With nearly two in three dual-eligible patients struggling with their health daily, it's clear that more needs to be done to provide a trustworthy, effective, and longitudinal care experience for this population and prevent costly consequences like avoidable delays in care and unnecessary ER visits. These results underscore the value of outcomes-based care models that take accountability for supporting members in navigating their healthcare benefits and for providing a more tightly coordinated healthcare experience. I'm optimistic about the progress we've seen towards Medicaid-Medicare integration, and I remain hopeful this will continue. These findings shine a light on the need to prioritize comprehensive physical, behavioral, and social care support for one of our nation's most complex and fast-growing populations."
In the same press release, Cityblock Health’s president Mike Roaldi added, “This survey uncovers gaps in our current system that affect not only the benefits of dual-eligible individuals, but the experiences they have in accessing and engaging in their care. With new CMS requirements on the horizon that will require all Medicare-Medicaid Plans (MMPs) to transition to Dual-Eligible Special Needs Plans (D-SNP), health plans and risk-bearing providers have a huge opportunity to address these barriers and provide more support for this population."
This is the latest survey conducted by Cityblock examining the experiences of people on Medicaid. In November of last year, the provider released the results of a study about the experiences of people in this program seeking treatment for mental health.2
At the time, Cityblock Health’s head of behavioral health and lead author of the study Ruby Mehta, LCSW, MBA, said, “Engaging those on Medicaid with mental and behavioral health conditions - especially more severe conditions like schizophrenia - is incredibly challenging. Treatment typically requires recurring visits to the doctor's office for LAIs which is not always possible as barriers to care like homelessness, distrust of physicians, lack of transportation and more, can drastically impact a patient's ability to seek treatment. This study intended to explore the effectiveness of our integrated value-based care model for advanced behavioral health which integrates specialized community health workers––or what I like to call "feet on the street”––with psychiatry and is designed to increase access to such interventions and services to prevent costly hospitalizations and readmissions."
Cityblock’s chief health officer Kameron Matthews, MD, JD, FAAP, added, “Despite their prevalence, behavioral health conditions often remain under-addressed, leading to poorer outcomes and higher costs, especially for Medicaid members. This study serves as further evidence of the efficacy of our Advanced Behavioral Health program, the importance of integration in a primary care model and the ability to address poor outcomes and deliver meaningful outcomes. I'm encouraged by the success of this program and the impact our integrated medical and behavioral health model can have for all our members who face behavioral health challenges."
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