CMS to Test Models for Beneficiary Engagement, Incentives, Behavioral Insights

The Centers for Medicare & Medicaid Services (CMS) are seeking input on models to increase engagement among multiple beneficiary populations in health self-management in order to generate better care and better health at lower costs.

The Center for Medicare and Medicaid Innovation (CMMI) hopes to test innovative models to increase the engagement of Medicare beneficiaries, Medicaid beneficiaries, Medicare-Medicaid enrollees, and/or Children’s Health Insurance Program (CHIP) beneficiaries in their health and healthcare.

The CMS defines engagement as “beneficiaries’ active involvement in behaviors and activities meant to improve their health status and outcomes.”

The CMMI is considering several models to test different methods of engagement of CMS beneficiaries in modifiable aspects of their healthcare. Examples might include improving engagement and self-management of diabetics in the care of their disease, improving adherence of acute myocardial infarction (AMI) survivors with prescribed cardiac rehabilitation, improving influenza vaccination rates, and encouraging medication adherence by patients with chronic disease.

Of particular interest to CMS are models that use evidence-based social and behavioral insights to improve beneficiary engagement. Interventions and engagements that utilize methods from behavioral economics, social psychology, incentive design and other methods to attract attention of beneficiaries, encourage enrollment in models and provide continued motivation for the beneficiary engagement in the model to improve health and healthcare activities are some of the main focus areas of interest.

In this current request for input (RFI), CMS seeks suggestions from beneficiaries and beneficiary advocates, insurers, managed care plans, and employers related to how incentives and behavioral insights may help to improve beneficiary engagement.

A future RFI will solicit ideas related to Medicare Parts C and D, Medigap organizations, Medicaid, Medicare-Medicaid beneficiaries, or CHIP managed care, and information related to value-based insurance design (VBID).

Source: CMS, August 21, 2014

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This entry was posted in Behavioral Health, Disease Management, Incentives, Medicaid, Medicare, Medication Adherence and tagged , , . Bookmark the permalink.
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