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In the recently released Policy and Technical Changes proposal, CMS proposes the creation of member advisory councils to participate in the governance of D-SNP plans. CMS believes that these councils will be a vital mechanism to engage members in “defining, designing, participating in, and assessing their care systems”.  

With the significant success seen in these committees in Medicare-Medicaid demonstrations and PACE plans, CMS will be extending the requirement to D-SNP plans starting in 2023.  The proposed rule requires that enrollee advisory committees be representative of the D-SNP population and provide input on improving access to covered services and health equity for underserved populations, among other topics.  

At Wider Circle, the driving force behind our mission is that we all need to be part of a group to thrive, so it should be no surprise that we believe strongly in the importance of including members’ voices in the planning and delivery of services.  We have built 1800 groups across 320 communities in 5 languages, engaging over 20,000 members who come together to learn how to engage with care and to motivate one another in building healthy, thriving communities.  Our Member Ambassador program recruits volunteers from our member groups who play a particularly vital role in leading our groups, and supercharge our success in changing hearts and minds.  Their skill at identifying challenges and issues faced by fellow members in turn helps our customers target members with the appropriate programs and provides an early warning system to help address issues before they become critical.  Our Member Ambassadors are highly engaged members and actively look for ways to contribute to improving the services that the population receives, making them ideal participants for the D-SNP enrollee advisory committees.  

With the value demonstrated by advisory committees and by our own Member Ambassadors, all plans serving senior populations, including not just D-SNPs but also straight Medicare Advantage plans, would benefit from looking at incorporating the member’s voice into the design and management of their benefits and services.  This will help drive improved care for all and create a more equitable and inclusive industry overall. 

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About the author: Kamal Gautam, SVP, Business Development

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