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Effective Medicaid Advisory Committees Should Include More Medicaid Members

  • Post category:Action Alert

At Families as Allies, we consistently emphasize that nobody knows better than people receiving services and their families how to make services and systems as helpful as possible. Families must be at every decision-making table as partners for systems to grow and improve in the ways our children need.

In May 2023, the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees state Medicaid programs, proposed two new state-level groups to increase beneficiary and family input into Medicaid programs: 1.) a Medicaid Advisory Committee (MAC) made up of at least 25% Medicaid beneficiaries to advise the state Medicaid program, and 2.) a group made up of just Medicaid beneficiaries to advise the MAC. These two groups would replace currently mandated Medicaid Medical Care Advisory committees.

By law, current Medicaid Medical Care Advisory committees must include “Board-certified physicians and other representatives of the health professions who are familiar with the medical needs of low-income population; members of consumers’ groups, including Medicaid beneficiaries, and consumer organizations such as labor unions, cooperatives, consumer-sponsored prepaid group practice plans, and others, and the director of the public welfare department or the public health department.” Although the law requires that these committees include Medicaid members, it does not specify how many. You can read more about Mississippi’s Medical Care Advisory Committee and its members on the Medicaid website.

Families as Allies supports replacing Medicaid Medical Care Advisory Committees with Medicaid Advisory Committees and associated Beneficiary Advisory Groups as reflected in this excerpt from our July 2023  public comments to CMS:

We especially appreciate and agree with recommendations regarding changes to the Medicaid Medical Care Advisory Committee and the formation of the Medicaid Advisory Committee (MAC) and the associated Beneficiary Advisory Group (BAG). We believe these two new groups and their proposed structure and composition have tremendous potential to improve the outcomes and cost-effectiveness of Medicaid-funded services. We recommend that states work with peer and family-run organizations and grassroots groups who are already engaged with different groups of Medicaid beneficiaries to develop the policies and procedures for these groups and to engage a representative and diverse group of beneficiaries from the very beginning. We also recommend that the appointment process of beneficiaries to these committees be done in partnership with these same groups.

The state of California recently launched a Medicaid members advisory group and shared initial findings about how to make such groups, including Beneficiary Advisory groups, as effective as possible. These are highlights from California’s findings:

Be intentional when identifying and supporting membership.

  • Composition and size. Ensure composition reflects your state’s Medicaid population. Include a diverse mix of races, ethnicities, gender identities, sexual orientations, physical and intellectual/ developmental disabilities, and uses of Medicaid services (e.g., members on waiver programs, managed care, fee-for-service). 
  • Recruitment. Effective recruitment requires a multipronged approach. Try leveraging provider networks, community-based organizations, managed care plans, and agency staff while using marketing events, social media, and print materials to get the word out.
  • Compensation. Members should be fairly compensated for their time and expertise.

Thoughtfully plan and prepare for meetings.

  • Format. Be consistent in meeting format, length, and cadence. Offer virtual meetings to accommodate members located across the state.
  • Translation. Real-time translation (in person and virtually) is important — at least in Spanish and American Sign Language (ASL). 
  • Meeting facilitation. Facilitation can make or break a meeting. An ideal facilitator for a Medicaid member committee would have rich experience working with the community, a strong understanding of the state’s Medicaid program, and a background and race/ethnicity that reflects the state’s Medicaid membership.
  • Meeting materials. Meeting materials should be easy to understand, free from jargon and acronyms, written at a sixth-grade reading level, and translated into members’ primary languages.

Set the committee up for success and sustainability.

  • Member support. Connect with committee members before and after meetings. 
  • Trust building. Building trust with members will not happen overnight but it is possible with patience and intention. 
  • Feedback loops. Follow up when members offer recommendations or raise concerns, even with recommendations that cannot necessarily be implemented. 
  • Impact measurement. Developing an evaluation component is key for ensuring committee sustainability. 

You can read the full report here. We appreciate the Lucille Packard Foundation sharing information about California’s Advisory group in the October 26, 2023 edition of its Children and Youth with Special Health Care Needs Network Newsletter.

Mississippi Medicaid already has a member advisory board. The Division shares, “DOM’s goal with this Member Advisory Board is to provide you with a safe space to share with us what is going well, what can be improved, and any new innovative ideas you may have. If you are chosen as a member of the board, you will receive a gift card after each meeting.” You can apply to be a member of the advisory board at this link. 

Families as Allies looks forward to working with the Mississippi Division of Medicaid to make sure Medicaid members and their families fully inform the Division’s decisions and programs.

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