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The importance of Ombudsman programs in supporting the transition from medicare-medicaid plans to dual special needs
Falguni Basnet1, Colin Killick2, Leslie Diaz3
1Harvard TH Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
Abstract:
In this paper, we examine the critical role of Ombudsman programs in facilitating the transition from Medicare-Medicaid Plans (MMPs) to Dual Special Needs Plans (D-SNPS) for dual-eligible members. As states implement this federally mandated transition, Ombudsman programs serve as essential supports for the dual-eligible population who are navigating complex healthcare changes. Through analysis of Ombudsman programs in California, Massachusetts, Rhode Island, and Michigan, we highlight how these services address beneficiary concerns, resolve access issues, and provide valuable insights to policymakers. We emphasize the importance of maintaining and potentially expanding Ombudsman programs during and after the transition to ensure person-centric, high-quality care for dual-eligible members.
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