The CMS guidance for putting together an Enrollee Advisory Committee requires that EACs be representative. Plan providers are asked to include a reasonably representative sample of the population enrolled in the dual eligible special needs plan or plans for each state where they provide a plan. Medicare Advantage organizations are also required to collect and use input from the committee to improve plan operations and governance including improving health equity.
In practice, this presents Medicare Advantage organizations with several challenges. The first challenge is to produce a good snapshot of who the plan participants are, beyond the obvious demographic or health variables. Our experience at Predict Health is that most providers lack this granular insight. They will need to take steps to augment the data they have.
Medicare Advantage organizations will also need to define and document the parameters they use to establish representativeness. An elegant option is to identify different composite personas for different plan participants and to recruit participants who closely match these personas. This prevents putting together a committee who is perfectly representative in terms of the age distribution but of nothing much else. Putting together defensible personas like this, built on data and not opinions, requires a more sophisticated and transparent approach to classification. We recommend working with a trusted third party with experience in creating real world classification models.
The explicit mandate to hear more from underrepresented groups presents a different kind of challenge. One effective strategy here is to work more closely with members of communities who work with disadvantaged groups and who might be able to credibly represent their viewpoints. Again, it will be necessary to have identified and documented the rationale behind the selection.
Identifying who to recruit, however, is easy when compared to the challenges of actually recruiting.
Predict Health recommends that Medicare Advantage organizations recruit participants in waves:
1) Email is by far the cheapest channel and so we recommend that organizations start here. We have found a series of short email sequences to be most effective. Given that your average participant likely receives the usual avalanche of spam, we recommend something short, designed to spark attention and with clear next steps. Needless to say, most MA organizations will need some dedicated help to run an effective sequence of emails.
2) We recommend following up emails with a second wave of direct mail. Mail is expensive but remains unusually salient and effective. Mail has the advantage of providing a little more space and so MA organizations can provide a little more background.
3) At some point, it will become obvious that the EAC is likely missing certain kinds of participants. This is where recruitment becomes a lot more targeted and involves phone and community outreach. Phone outreach needs to be handled carefully given that plan participants will not be used to being directly outreach contacted. A careful campaign to build awareness before individuals are contacted can make it far more likely that outreach will be successful. Community outreach can be similarly complicated and so it makes sense to rely on trusted intermediaries who already have the right contacts.
As the day of the EAC nears closer, we recommend that plans remind committee members of their commitment. You need to make sure that you verify emails and phone numbers to do this well. We recommend that any reminder communications re-iterate the ask and also identify the benefits that come from attending. While committee members can’t be directly paid, it’s still possible to provide them with a good lunch and to make them feel important and respected throughout the event.