Presented by: Alexis Henry University of Massachusetts Medical School August 15, 2013

1. MassHealth Proposal:Assessing the Early Perceptions and Experiences of One Care Among MassHealth Members Presented by: Alexis Henry University of Massachusetts Medical School August 15, 2013

2. Proposed Overall Project Goal • Assess member’s early perceptions and experiences of One Care • Use a mixed-method approach • Include members who have: • Self-selected into One Care • Been auto-assigned into One Care • Opted-out of One Care

3. Domains Assessed • Enrollment Process • Clarity of information; easy/difficult; questions answered; etc. • Care Team • Same/different providers; care coordinator; LTS coordinator; etc. • Care planning/assessment process • Communication with team; appointments; preferences and concerns addressed; etc. • Care plans • Service needs addressed; continuity/change in care; satisfaction with care plan; etc. • Service delivery • Obtaining needed services; interactions with providers; etc. • Overall perception/satisfaction with One Care • Satisfaction with plan/providers; ongoing concerns about One Care; etc.

4. Proposed Methods • Mixed method with three approaches • Focus groups • Surveys • Review of “indicators” reported by MassHealth and contracted entities • Project timeframe - October 2013 to March 2015 • Project team/workgroup • UMMS staff from CHPR, CHLE; survey contractor; One Care Implementation Council members

5. Focus Group Methods • Late 2013 through July 2014 • 5 focus groups with 8-12 eligible enrollees each (n=60) • 1 group with early opt-out eligible enrollees • 1 group with early opt-in enrollees • 3 groups with opt-in or auto-assigned enrollees • Members randomly selected and invited by phone • Suffolk, Worcester, Hampden, Hampshire counties • Focus group questions developed by Project Team

6. Focus Group Methods • 1 group in Spanish, rest in English • $50 stipend; ASL and other accommodations • Groups audio-recorded; transcripts analyzed thematically • Interim and final reports • Information from first 2 groups will help inform development of enrollee surveys

7. Survey Methods • Two surveys • Survey 1 – experiences of eligible enrollees during initial enrollment period • Survey 2 – experiences of enrollees in One Care • Survey questions developed by Project Team • Input from Implementation Council • Review program documents, existing surveys • Informant interviews

8. Survey 1 – Enrollment Period • Administered after eligible enrollees receive information about One Care • Oct – Dec 2013 • Brief (5 minute) telephone survey of randomly selected members in 3 groups • Self-selected into One Care (early opt-in) n=100-125 • Opted-out of One Care (early opt-out) n=100-125 • Neither opt-in nor opt-out (waiting) n=100-125 • Questions focused on enrollment materials and experience • Clarity of materials; assistance sought; questions answered; reasons for opting-in or out • Summary report in February 2014

9. Survey 2 – Experiences with One Care • Comprehensive look at enrollees’ early experiences in One Care • Administered to 6,000 randomly selected enrollees in 3 waves (2,000 each wave) • Goal of 50% response rate or n=3,000 respondents • 120 days after each auto-assignment wave • January 2014 surveyed May-June 2014 • April 2014 surveyed July-August 2014 • July 2014 surveyed in November-December 2014

10. Survey 2, continued • Dual-mode (mail and phone) administration • 2 mailings with follow-up by phone • English and Spanish • 10-15 minutes by phone; 70-80 questions with skips • Survey sample may be selected to ensure representation of certain subgroups • E.g. PCA or DME users; One Care Plans • Interim reports; final summary report in March 2015

11. Review of early “indicators” • Data elements available from MassHealth; One Care Plans; Ombudsman; SHINE; MassHealth Customer Service • # electing to enroll; # opting out; # cases opened, # cases closed; # complaints and complaint resolutions; # appeals and appeal resolutions • Regular review of indicators as they become available • Monthly update of enrollment data to Implementation Council • Quarterly summary “dashboard” for Implementation Council • Additional analyses may be warranted if a sufficient amount of data accumulates

12. Questions and Comments