Medicare Conference Call: Getting Ready for 2006
October 20, 2004
Summary
The October 20th Medicare conference call began the process of strategic thinking and planning as we prepare for major changes within Medicare as a result of the Medicare Modernization Act (MMA) of 2003. Although many of these changes, particularly the addition of a prescription drug benefit (Part D) to Medicare, will not occur until January 1, 2006, SHIPs must be prepared well before January 1, 2006 to educate beneficiaries about the various decisions that they will need to make in a timely manner to avoid any adverse consequences. The tasks ahead are large and labor-intensive, and we must begin preparing now. HAP has created a MMA timeline that we at HAP will follow in preparing resources for the SHIPs and other programs to use as they undertake their training, partnering, and outreach. We encourage you all to use this timeline as well as you lay out your strategic workplan for the upcoming year. This call focused largely on four areas within strategic planning: training; partnerships; outreach and messages; and data. Participants shared many great ideas.
Training
In an effort to maximize SHIPs resources during a time when there will be many substantial changes within Medicare, call participants suggested different strategies to train counselors.
- Allow counselors to choose a topic area to specialize in and hold in-depth trainings for these counselors. This will limit the amount of training and other resources that both programs and counselors will need to devote to certain topics, such as Medicare Part D and long-term care insurance.
- Schedule training according to upcoming changes or events in Medicare. In other words, break larger topics up into more manageable sections that pertain to an upcoming time period.
- Hold regional quarterly conference calls with coordinators.
- Conduct continuing education classes.
- Train counselors on computers in general and on PDAP in particular, which will be the comparison tool for Part D plans.
Partnerships
Because SHIPs resources are limited as are the number of months to prepare for 2006, forging new partnerships and strengthening existing ones with local, community-based organizations is essential for SHIPs to be able to first reach specific populations of beneficiaries and then educate and counsel beneficiaries. Many of the “usual suspects” were mentioned including social workers, health care providers, and senior housing managers. These community partners can help SHIPs send appropriate messages to targeted populations.
State agencies, including State Medicaid Agencies and Public Aid or Department of Health and Human Services, are essential partners to reaching and meeting the needs of low-income Medicare beneficiaries, particularly dual-eligibles. One SHIP has held several conferences with the Public Aid Office and Department of Human Services to assure that dual-eligibles are educated about the critical changes that will be occurring and are equipped to make informed decisions about their prescription drug coverage.
Several other states mentioned partnerships that already exist.
- Department of Aging, Department of Insurance, State Medicaid Agency, and Social Security Administration
- AARP and Social Security Administration
- Social Security Administration, AARP, State Medicaid Agency, and Department of Aging
- State Office of Aging and local Social Services
One barrier that was mentioned was the lack of “cooperation” among Medicaid case workers or social workers. Several states noted that often these workers do not want to take any responsibility for Medicare issues. They feel it is the SHIPs job to educate and counsel Medicare beneficiaries, even if the beneficiaries are also Medicaid recipients. We will have an opportunity to discuss partnerships more during HAP’s next Medicare conference call on November 17, 2004.
Messages and Outreach
Possible messages for the SHIPs as 2006 approaches were discussed. There was consensus that messages should not try to educate beneficiaries, but rather direct beneficiaries to the SHIPs for education and counseling. The messages should be simple and clear. Some possible messages related to Medicare Part D in 2006 are:
- “Everybody has to make a choice about their prescription drug coverage. SHIPs can help.”
- “To not make a choice is the wrong choice.”
In addition to the "usual suspects," i.e., churches and hospitals, as places to deliver a message and educate beneficiaries, other avenues for outreach were suggested:
- “earned media,” such as having news coverage at an event that the SHIP is participating in;
- State Legislators are also an outlet to disseminate the message that SHIPs can help;
- Public Service Announcements (PSAs); and
- commercials on local television stations.
Data, Data, and More Data
The Centers for Medicare and Medicaid Services has made it very clear that SHIPs must be able to demonstrate that their work is having an impact on Medicare beneficiaries. Data collection is essential to this demonstration of success. Data on the number of beneficiaries counseled as well as on the outreach efforts that SHIPs are engaging in are two crucial components.
Additionally, SHIPs need to think “outside-the-box” and find ways to demonstrate, through data, that their outreach efforts drive Medicare beneficiaries to local sites for 1:1 counseling.
As always, please share any comments or ideas with Hilary Dalin at hdalin@healthassistancepartnership.org or Lee Thompson at mailto:atlthompson@healthassistancepartnership.org.
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