More than 450,000 "dual eligible" adults (those insured through both Medicare and Medi-Cal) in eight California counties are slated to be moved from fee for service to managed care starting in April 2014. New data from the UCLA Center for Health Policy Research's HOME project find that those who will be affected by the transition are often confused or concerned about its potential effects on their health care. This vulnerable group of consumers with multiple chronic illnesses and disabilities is unevenly responsive to the program information received, depending in large part on the older adult's physical or mental state and on the availability of family or other supportive resources. Most of these consumers would like to receive information in a more personal and interactive manner than the typical mailed notices. This policy note recommends the implementation of targeted and tailored communication efforts that are responsive to the diverse information needs and preferences of these vulnerable older adults.
One strategy for information assistance is the use of patient navigators, as done during implementation of the Affordable Care Act. Such people would be specifically trained to respond to the needs of the dual eligible population. This approach would be especially helpful for older adults who are less engaged and are likely to benefit from direct support. In addition, collective and collaborative communication efforts initiated by community-based organizations and local government agencies can provide critical point-of-information dissemination and assistance, with multiple pathways used to reach and follow up with those older adults who are most at risk for experiencing gaps in the receipt of essential medical and social care.