Evaluation of the Senior Medicare Patrol program

Medicare pays $566 billion annually for more than 50 million beneficiaries. The program estimates that 3-10% of billings are lost due to improper payments, including errors, fraud, and abuse.

The Senior Medicare Patrol (SMP) program was established in 1997 and receives grants from the Administration for Community Living to recruit, train and support a network of volunteers to reach and educate Medicare beneficiaries to recognize and report fraud, error, and abuse.  The primary goal of the SMP program is “to empower seniors to prevent health care fraud through education and outreach.”  The program operates in every state and the U.S. territories, engaging seniors via group education and one-on-one counseling sessions, media, and other activities.

We will present preliminary results from an evaluation of SMP educational sessions designed to assess the program’s effects on attitudes and behaviors among participating beneficiaries that could lead to reductions in error, fraud, and abuse.  This study uses a pre-post with control group design to survey participants and controls. Data are being collected in 7 states (Arkansas, Florida, Maine, Massachusetts, Michigan, Oregon and Texas). The survey measures were based on a review of existing literature on prevention programs and the behavioral theories that underpinned them and includes items related to healthcare consumer behavior (including fraud detection and abuse prevention), patient engagement, and shared decision-making among SMP program participants. We will share key lessons from our comprehensive review, preliminary data from the evaluation, as well as implications for patient engagement, education, and health communication among seniors.