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Consumer input may improve health outcomes for Medicaid enrollees, study finds

OHSU researchers interview program leaders across 14 states, identify ways to improve service delivery
Closeup shot of a doctor's hands writing notes on a pad during a consultation with a patient
OHSU-led research suggests that consumer engagement can help to improve Medicaid program service design and implementation. (Getty Images)

More than 75 million people are currently enrolled in Medicaid, making it the largest source of public health insurance in the United States. While the program has successfully increased access to care across multiple states, including Oregon, barriers to necessary health services for highly vulnerable populations – including children, older adults and those of lower socioeconomic status – still exist.

headshot of Jane Zhu, M.D., M.P.P., M.S.H.P., a smiling Asian woman with long black hair
Jane Zhu, M.D., M.P.P., M.S.H.P.

“As Medicaid programs grow in scale and complexity, increasing consumer input may help to guide – and in some cases, improve -- successful program design at the state level,” says Jane Zhu, M.D., M.P.P., M.S.H.P., assistant professor of medicine (general internal medicine) in the OHSU School of Medicine, and health systems management and policy in the OHSU-PSU School of Public Health. “However, little is known about the extent to which state agencies are currently engaging consumers in the design and implementation of programs and policies, and how this is being done.”

To help expand this understanding, in conjunction with University of Pennsylvania and University of Minnesota, Zhu and colleagues at the OHSU Center for Health Systems Effectiveness interviewed 50 Medicaid program leaders across 14 states to determine if, and how, consumer engagement is used to improve system processes. Program leaders were selected based on various factors, including U.S. census region, Medicaid enrollment size and Affordable Care Act expansion status.

“Despite known challenges associated with obtaining feedback from historically underserved and hard-to-reach populations, we found that several states are effectively investing in meaningful, innovative ways to engage consumers to help identify areas where service design and implementation may be improved,” says Zhu. “Creating a formal mechanism, or forum, for states to share their learnings and best practices could help strengthen consumer engagement efforts across more states, particularly in those not yet investing in such practices.”

Examples of consumer engagement strategies practiced by select states sampled are summarized here; the complete study is available online in the Milbank Quarterly.

This research is supported by the Robert Wood Johnson Foundation.

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