Improving the Medicare Market Adding Choice and Protections (1996) / Chapter Skim
Currently Skimming:
H Reaching and Educating Medicare Benificiaries About Choice
H Reaching and Educating Medicare Benificiaries About Choice
Pages 236-269
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From page 236... ...
Recent and proposed legislation will further increase the options available to beneficiaries by allowing additional types of health care arrangements such as preferred provider organizations, point-of-service plans, and provider service networks. The introduction of managed care as a choice in the public sector reflects the growth of managed care offerings to active workers by many private sector employers.
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From page 237... ...
The case examples, largely drawn from telephone interviews and a review of program materials, are organized by information source including public agencies (such as the Health Care Financing Administration or public libraries) , nonprofit organizations, private companies, employers, and health plans.
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From page 238... ...
with Medicare contracts: "Marketing includes activities undertaken by an HMO/CMP to generate good will, encourage individuals to enroll in or remain in a prepaid health plan, or to provide information on plan benefits or costs and membership rules" (Health Care Financing Administration, 1992a)
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From page 239... ...
and owned a VCR (56 percent) , up from 49 and 43 percent, respectively, in 1988 (Modern Maturity/The Roper Organization, 1992)
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From page 240... ...
In contrast, older adults are skeptical of ads that carry celebrity endorsements and those that use slogans such as "new and improved" (Modern Maturity/The Roper Organization, 1992)
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From page 241... ...
COMMUNICATING WITH OLDER ADULTS ABOUT MANAGED CARE AND MEDICARE CHOICES Review of the Literature A discussion about communicating with Medicare beneficiaries about their health care options, including managed care, should begin with a discussion of the extent of their knowledge about the Medicare program in general. If older adults do not understand the basic Medicare program, it is not likely that they can be informed enough to understand their health care options beyond the basic program.
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From page 242... ...
A final study found similar results when surveying Medicare HMO and social/health maintenance organization (S/HMO) enrollees (a S/HMO is a health plan that combines Medicare HMO coverage with chronic care benefits and services such as per
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From page 243... ...
Focus Group Research Another source of information about preferred sources of information about Medicare and health plan options comes from recent focus groups and structured interviews held with Medicare beneficiaries. A series of 15 focus groups conducted in the fall of 1993 for the Kaiser Family Foundation looked at a series of issues related to the overall Medicare program (Mellman, Lazarus & Lake, 1994)
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From page 244... ...
. Other preferred sources of information included seniors centers, public libraries, post offices, county aging service agencies, and Social Security offices.
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From page 245... ...
CASE EXAMPLES OF DIFFERENT MEDIA USED TO DISTRIBUTE INFORMATION ABOUT HEALTH PLAN CHOICE AND MANAGED CARE Print Media: Pamphlets, Reports, and Guides Public Agencies To date, most of the information distributed to Medicare beneficiaries by HCFA about health care choices and managed care has been in a print format. Federal information dissemination about Medicare health care options is tiered.
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From page 246... ...
or to another HCFA brochure entitled "Medicare Managed Care Plans" (Health Care Financing Administration, 1995b) , available through the Consumer Information Center in Pueblo, Colorado.
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From page 247... ...
Medicare managed care is described as one of the private health insurance options that covers Medicare gaps along with Medigap policies, continuation of employer coverage, long-term-care insurance, hospital indemnity policies, and specific disease policies (Health Care Financing Administration, 1995c)
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From page 248... ...
The comparison chart is distributed primarily through Social Security offices and senior health insurance counseling programs and directly to approximately 1,500 beneficiaries who have requested it. HCFA is in the process of developing similar comparative charts for other regions that they plan to have available in disc format and on-line for regional offices and other interested organizations by early next year.
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From page 249... ...
Their Medicare managed care piece entitled "Medicare Health Maintenance Organizations: Are They Right For You? ," is a 10-page pocket-size brochure that provides an overview of Medicare HMOs and that discusses how they work, what a beneficiary should consider before enrolling, enrollment/disenrollment procedures, and the complaints/appeals processes (Medicare Beneficiaries Defense Fund, 1994)
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From page 250... ...
. Health Plans Managed care plans that offer products for Medicare beneficiaries use print media in a number of ways to communicate with older adults about their products.
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From page 251... ...
The direct mail material might encourage the recipient to send for more information, call a toll-free plan number for more information, or attend a meeting where additional information about the product will be presented by their representatives. Print Materials: Newspapers and Magazines Nonprofit Organizations The Minnesota Health Data Institute, a nonprofit publicprivate organization created by the Minnesota State Legislature in 1993 with the overall goal of improving the quality of health care services available to Minnesotans, has recently released the results of a statewide survey of consumers on their satisfaction with health plans (Minnesota Health Data Institute, 1995)
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From page 252... ...
Local senior citizens' newspapers are another potential source of information for Medicare beneficiaries about local health plan and managed care options. The April 1995 edition of Arizona Senior World, for example, included a comparison chart of HMOs available to Arizona residents (Arizona Senior World, 1995)
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From page 253... ...
. Health Plans Health Plans use print advertising to reach older adults, often advertising in metropolitan newspapers, senior citizens' newspapers, and other local print media.
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From page 254... ...
Health plans, or any other entity conducting telemarketing, would now be subject to Federal Trade Commission regulations prohibiting deceptive and abusive telemarketing practices under the 1994 Telemarketing Act. Among other things, the regulations limit the time of day that individuals may be called, requires disclosure that the purpose of the call is to sell goods or services, and prohibits unsolicited calls that are coercive or abusive.
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From page 255... ...
Several of the radio efforts target specific ethnic communities including Spanishspeaking and Chinese-American Medicare beneficiaries. The HCFA Office of Research and Demonstration is currently funding a contract to develop a beneficiary information, education, and marketing strategy to support a proposed demonstration on expanded choice of Medicare health plan options.
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From page 256... ...
Employers The employee benefits consulting firm Towers Perrin, in conjunction with GHAA, has developed a 13-minute videotape as part of the multiemployer, multicity retiree project described above. The videotape uses an older female narrator speaking words from actual letters that senior citizens have sent to health plans.
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From page 257... ...
Nonprofit Organizations Several nonprofit organizations for senior citizens are involved in the dissemination of on-line health information to older adults. One of the oldest is SeniorNet, a 9-year-old nonprofit membership organization based in San Francisco.
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From page 258... ...
There is, however, a section about the Medicare program, including information about how
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From page 259... ...
at the Social Security office kiosk. SSA staff will evaluate the kiosk program in 1996 for possible replication in other areas and are also talking about making the kiosk software available for replication to other states (Georgia and North Carolina)
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From page 260... ...
In addition to disseminating information to consumers through the newspaper (referenced above) , the Minnesota Health Data Institute also held a series of three community meetings to present the findings on consumer satisfaction with Minnesota health plans.
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From page 261... ...
The topics discussed included quality, access, financing, and long-term care and included perspectives from other states. Health Plans Health plans extensively use community meetings as a way to interest Medicare beneficiaries in their HMO product.
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From page 262... ...
The project will specifically explore the feasibility of providing a counseling service and related products designed to provide unbiased consumer information to Medicare consumers who are in the process of choosing a managed care plan, as well as a self-assessment instrument and related publications. Included in the study is an investigation of potential markets for the counseling and related products, such as the ICA programs, employers, unions, professional and retiree associations, and managed care organizations.
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From page 263... ...
A first finding is that any effort to communicate with beneficiaries about the choices that they now have or expanded future choices must be done in the context of low levels of Medicare beneficiary understanding of how the basic Medicare program works. Any discussion about the preferred communications channels for reaching older adults about their health plan options must therefore be preceded by a strategic understanding of what Medicare beneficiaries currently know.
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From page 264... ...
Some of the organizations, such as HCFA, public libraries, nonprofit organizations, newspapers and magazines, and the seniors' counseling programs, are attempting to educate beneficiaries generally, or specifically in the case of counseling, about their health plan choices. Other organizations, such as health plans with Medicare contracts, are attempting not only to educate but also to enroll beneficiaries in their plans.
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From page 265... ...
The first is that "family and friends" should probably also be the target of any information campaigns to help older adults make informed decisions about their health plan choices. Second, the person-to-person outreach widely used by Medicare HMOs in the form of group and individual meetings is probably particularly persuasive in interesting older adults in managed care.
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From page 266... ...
1994. National Survey of Employer-Sponsored Health Plans.
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From page 267... ...
1995 Benefits Comparison: Northern California, Southern California, Arizona and Nevada. San Francisco: Health Care Financing Administration.
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From page 268... ...
Saint Paul: Minnesota Health Data Institute. Modern Maturity/The Roper Organization.
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From page 269... ...
1982. Barriers to the Health Maintenance Organization for the Over 65s.
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