Our Work

L&M, with partner NORC at the University of Chicago, supports CMS efforts to monitor and improve the performance of Medicare Advantage (Part C) and prescription drug (Part D) programs. L&M provides continuous monitoring to ensure patient access to Part D sponsors’ pharmacy networks through comprehensive quarterly geographic analyses. L&M evaluates total costs and patient cost-sharing for commonly-filled Part D prescription drugs, characterizes prescription fill patterns, and assesses differences in access for such drugs based on convenient access standards, pharmacy desert distributions, and beneficiary characteristics and cost-sharing burden. Additionally, the team analyzes language needs among Part C and D plan sponsors to better identify translation requirements, examines the potential benefit of dual eligible special needs plans for partial-benefit Medicare-Medicaid enrollees, and characterizes geographic and other inequities in enrollment into higher-quality Medicare Advantage plans. L&M’s data collection and analyses inform CMS’ policymaking and monitoring initiatives, focusing on emerging areas within the Part C and Part D programs.

L&M, with partners Tantus Technologies and Mathematica, provides support services and technical assistance to CMS by triaging, reviewing, and summarizing public comments received in response to Notices of Proposed Rulemaking (NPRMs) and other public comment cycles. L&M has supported various public comment periods, including the Medicare Physician Fee Schedule (PFS) proposed rule, Interim Final Rules with Comment periods (IFCs), Part C/Part D regulations, the Advance Notice, and the Medicare Hospital Outpatient Prospective System (OPPS)/Ambulatory Surgical Center (ASC) Payment System proposed rule. During each comment period, L&M triages, reviews and summarizes up to tens of thousands of comments (40,000+ for the PFS; 17,000+ for the Advance Notice and Part C/D regulations; and 2,000+ for the IFCs). Additional responsibilities include managing CMS’ resource mailbox to process, track, and respond to inquiries year-round. This also involves providing technical assistance in reviewing preamble and regulations text and updating existing CMS publications and sub-regulatory guidance.

The CMS Office of Communications (OC) is responsible for communicating with a wide range of audiences using a variety of outreach and education formats, with the goal of ensuring that audiences are able to make informed decisions and use the services, programs and tools available to them. L&M conducts qualitative, quantitative and mixed method research to gather information from Medicare target audiences so that their perspectives can be incorporated into the development, refinement and improvement of outreach and education materials and strategies. Ongoing activities include:

• Examining communication needs, preferences, and appropriate outlets and channel preferences for outreach around various topics
• Examining current and changing characteristics of Medicare target audiences, particularly factors that may affect how information is received and understood
• Examining the communication environment and how it may impact exposure or access to and understanding of outreach and education
• Informing development, improvement, targeting, and dissemination of outreach campaigns, educational materials and content, messaging concepts, and messages for their intended Medicare audiences
• Informing strategic approaches for outreach and education activities
• Synthesis and integration of research findings

CMS continually works to develop and improve decision support resources to help Medicare consumers examine and understand their options so they can access the coverage, providers, and care that best meets their needs. L&M performs qualitative research to provide CMS with the consumer perspectives needed to inform, develop, and improve Medicare decision making tools and information. This research involves usability testing; cognitive interviews, focus groups, and small group discussions; literature reviews, environmental scans, and desk audits; and secondary analysis of previous user research studies.

L&M assists CMS with qualitative, quantitative, and mixed methods consumer research to support the improvement of website tools, information, education, and on- and off-line decision support materials for HealthCare.gov, the federally-facilitated Health Insurance Marketplace. The team collects data through individual interviews, focus groups, and surveys with relevant audiences (for example, Marketplace-insured participants, uninsured participants) and analyzes the data to provide research findings and recommendations for improving user experience of HealthCare.gov and other Health Insurance Marketplace resources for consumers. L&M focuses on topics such as:

• Enhancing the application process
• Enhancing choice architecture during the plan selection process
• Ensuring that users can find key information about the Marketplace
• Ensuring that users can find live help
• Understanding consumers' mental models related to health care and health insurance

Millions of eligible older adults remain unenrolled in public benefits due to administrative burden and complex application processes. Under cooperative agreements with the U.S. Administration for Community Living (ACL), the National Council on Aging (NCOA) has partnered on several projects with L&M to advance strategies that streamline enrollment into public benefits for older adults. Across two complementary projects, L&M supported NCOA by combining state-level implementation research and broader stakeholder engagement to identify and disseminate best practices and strategies to improve access to benefits for older adults.

From 2024 to 2025, L&M conducted a series of five state case studies focused on streamlining enrollment into Medicare Savings Programs (MSPs), which help low-income older adults cover Medicare premiums and cost sharing. The team conducted an environmental scan to identify states using promising enrollment strategies, such as aligning eligibility rules and leveraging Medicare Part D Low-Income Subsidy (LIS) application data, and selected a diverse set of states for in-depth study. Through interviews with state officials and other stakeholders, L&M documented effective practices, implementation challenges, and lessons learned, producing case studies and companion materials designed to help other states replicate successful approaches.

In another project, L&M supported NCOA in developing a strategic engagement plan to increase awareness of enrollment barriers facing older adults and identify opportunities to reduce administrative burden. Through an environmental scan and interviews with organizations working in public benefits policy, research, and technology, L&M gathered insights on emerging priorities and collaboration opportunities. These findings identified practical outreach and engagement strategies to support NCOA’s internal strategy for more efficient, accessible public benefits enrollment systems for older adults.

L&M, along with partner AcademyHealth, provided strategic, analytical, and programmatic support for various CMS Office of Minority Health (OMH) initiatives. L&M supported health care provider organizations, health plans, states, territories, and Tribal Nations in advancing health equity through targeted capacity building, technical assistance, and data-driven interventions. Core aspects of L&M’s work included:

• Learning Systems and Communities of Practice: For the Minority Research Grant Program (MRGP), in collaboration with AcademyHealth, L&M designed and managed a learning system and community of practice for grantees. The team delivered technical assistance through bimonthly webinars and monthly newsletters to support grantee readiness, planning, and professional development, and conducted program evaluation. For the Tribal Data Learning Community (TDLC), L&M developed and facilitated a program providing Tribal Epidemiology Centers with Medicare and Medicaid data access, technical assistance, and monthly peer learning sessions to build capacity for data analysis and utilization.
• Qualitative Research and Storytelling: L&M conducted multi-phase in-depth and in-person interviews with individuals and caregivers from priority populations nationwide to document their experiences accessing health care through Medicare, Medicaid, and the Health Insurance Marketplace. Interview findings culminated in (1) individual interview summaries, (2) synthesis reports highlighting key themes, and (3) professionally edited videos created in partnership with production teams that amplified interviewees' lived experiences for broader dissemination.
• Stakeholder Engagement and Advisory Support: L&M synthesized stakeholder feedback from CMS events and established operational infrastructure for the Agency's Health Equity Advisory Committee (HEAC). The team completed HEAC member selection, coordinated initial stakeholder engagement activities, and developed comprehensive onboarding processes, meeting facilitation plans, and materials.

L&M conducted formative research on behalf of the Alzheimer’s Association exploring perceptions and attitudes around early detection of Alzheimer’s disease and dementia. Additionally, L&M explored whether information regarding new medications for Alzheimer’s administered in the early stages of the disease affected participants’ perceptions and attitudes. L&M conducted focus groups with a range of impacted populations, including individuals who identified as:

• African Americans (urban and rural)
• American Indian and Alaska Natives (AI/AN) (urban and rural)
• Asian American/Pacific Islanders (AAPI) (urban)
• Non-Hispanic Whites (urban and rural)
• Spanish-speaking Hispanics (urban)

L&M provided recommendations to inform the development of key concepts and messages to be part of communication efforts to encourage early diagnosis of Alzheimer’s.

L&M, along with partner NORC at the University of Chicago, assisted the State Demonstrations Group (SDG) in the Center for Medicaid and CHIP Services (CMCS) to evaluate and monitor Medicaid Section 1115 demonstrations. Section 1115 of the Social Security Act authorizes the Secretary of the Department of Health and Human Services (HHS) to approve experimental, pilot, or demonstration projects to allow states flexibility to test unique approaches to program design and administration that are aimed at enhancing beneficiary access to quality services. The team delivered technical and analytical support by monitoring and evaluating state demonstration program reports, evaluation designs, evaluation reports, and implementation protocols. The team assessed monitoring and payment protocols, along with other documentation, to provide recommendations. L&M’s reviews and recommendations focused on ensuring the comprehensiveness, scientific and technical merits of state reports, and adherence to CMS requirements.

AHIMA sought to understand how health information management (HIM) professionals and the organizations within which they work understand and comply with the information blocking (IB) provisions set forth in the 21st Century Cures Act. These regulatory requirements were designed to facilitate the access, exchange and use of electronic health information (EHI). L&M worked with AHIMA and Alazro Consulting to select and interview a range of 10 hospitals and health systems representing different levels of system capacity and compliance readiness. L&M conducted semi-structured interviews with health system executives and staff — including HIM professionals, information technology staff, and compliance officers — to understand: 

• How HIM professionals and health care organizations manage the release of EHI
• How these professionals and organizations planned to comply with IB rules, while meeting varied state and federal privacy and release of information rules
• Challenges that AHIMA members face and their needs related to training, education, building standard operating procedures, and other areas around IB compliance.

The interview findings culminated in (1) an overarching report of key themes, (2) case study briefs describing two of the health systems in greater detail, and (3) a conference abstract and podium presentation at the 2023 AcademyHealth Annual Research Meeting. Find the case studies here: 

Information Blocking Compliance Case Study: Mass General Brigham (MGB) 

Information Blocking Compliance Case Study: CommonSpirit Health 

L&M provided scientific, analytical, technical assistance, dissemination, and logistical support to AHRQ and the multi-stakeholder grantee teams in the Pediatric Quality Measures Program (PQMP). PQMP was established to improve the quality of care delivered to children covered by Medicaid and the Children’s Health Insurance Program (CHIP) by implementing newly developed measures across state, health plan, health system and provider levels. In collaboration with AHRQ, L&M provided analytical support to grantee teams through an established learning collaborative. Our team answered key research questions identified by AHRQ and developed quality improvement (QI) toolkits alongside grantee teams. Using an Implementation Science framework, we documented contextual factors influcencing QI efforts. Additionally, L&M delivered general dissemination support and led the initiative to publish research articles and commentaries in an Academic Pediatrics journal supplement journal supplement.