Julie Franklin, MBA¹, Beth Simon, PhD¹, Kate Heinrich, MA¹, Susan Hollman¹, Jack H. Fyock, PhD², Kelly J. Dougherty³, and Christopher Koepke, PhD⁴. (1) Centers for Medicare & Medicaid Services, 7500 Security Blvd, Baltimore, MD 21244, 410-786-8126, jfranklin@cms.hhs.gov, (2) Health Services Research & Management Group, BearingPoint, Inc., 1676 International Drive, McLean, VA 22012, (3) Health Services Research and Management Group, BearingPoint, Inc., 1676 International Drive, McLean, VA 22012, (4) Center for Beneficiary Choices, Centers for Medicare & Medicaid Services, 7500 Security Blvd., Mailstop S1-15-03, Baltimore, MD 21244-1850

Background: The Medicare Modernization Act of 2003, builds on the Balanced Budget Act of 1997 by expanding Medicare beneficiaries’ choices for health care delivery. Both acts provide opportunities for beneficiaries to behave like health care consumers by choosing the health plan option that best meets their needs. To act as consumers and make informed choices, beneficiaries must understand their options under Medicare. Purpose: The project used social marketing research techniques to develop tools for communicating health plan options to beneficiaries. Methods: Exploratory interviews were conducted with insurance industry representatives and six exploratory consumer focus groups were conducted in Philadelphia and Ft. Lauderdale. Various tools were developed to communicate health plan choices and were tested with six focus groups in Las Vegas and Phoenix and 53 in-depth interviews in Baltimore and Philadelphia. Results: Many beneficiaries were not aware of different choices available. Furthermore, many did not realize the Medicare option in which they were enrolled. They were also unfamiliar with the terms used to describe options including: Original Medicare, M+C, Preferred Provider Organization and Managed Care Plan. Instead, they differentiated options by health plan characteristics such as, less paper work, limited to network doctors, and set co-pay. Beneficiaries preferred an overview of the options limited to one page, with more details presented later. Conclusions: Typical health insurance language is unfamiliar to Medicare beneficiaries. Tools using beneficiary-centered language more successfully communicate health plan options. Research resulted in a one page description of Medicare health plan options to be shared at the presentation.

Learning Objectives:

• Understand how older adult consumers differentiate their Medicare health care options.
• Learn methods for effectively communicating Medicare health plan options.
• Understand the application of social marketing research to develop methods for communicating with older adults.

Keywords: Medicare, Communication

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Centers for Medicare and Medicaid Services
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.