U.S. Department of Health and Human Services

Pilot Long-Term Care Awareness Campaign: Phase I Final Report

Executive Summary

MEDSTAT

February 24, 2006

This report was prepared under contract #HHS-100-03-0022 between the U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and MEDSTAT. For additional information about this subject, you can visit the DALTCP home page at http://aspe.hhs.gov/_/office_specific/daltcp.cfm or contact the ASPE Project Officer, Hunter McKay, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201. His e-mail address is: Hunter.McKay@hhs.gov.

The opinions and views expressed in this report are those of the authors. They do not necessarily reflect the views of the Department of Health and Human Services, the Research Triangle Institute or any other funding organization.

The Department of Health and Human Services (HHS) designed and implemented the Phase I Long-Term Care Pilot Awareness Campaign, called "Own Your Future," to promote increased awareness among recent retirees and near retirees about the importance of planning ahead for future long-term care needs. Specifically, in January 2005, the Office of the Assistant Secretary for Planning and Evaluation, the Administration on Aging and the Centers for Medicare and Medicaid Services, working closely with the National Governors Association and the National Conference of State Legislatures launched the "Own Your Future" Pilot Long-Term Care Awareness Campaign in five states: Arkansas, Idaho, Nevada, New Jersey and Virginia.

Many people today do not think about their future long-term care needs and therefore fail to plan appropriately. If individuals and families are more aware of their potential need for long-term care, they are more likely to take steps to prepare for the future. From a public policy perspective, increased planning for long-term care is likely to increase private financing, and may reduce the burden on public financing sources.

Campaign Materials and Activities

The Campaign used materials that were developed, tested and approved by the HHS as part of an earlier awareness effort. These materials included:

• Tri-fold brochure with tear-out business reply postcard offering the Long-Term Care Planning Kit.
• Television and Radio spot featuring a boomer-aged woman who is thinking about her father's long-term care needs when she realizes that she should begin to plan ahead for herself as well.
• Follow-up postcard reminding consumers to order the Long-Term Care Planning Kit.
• The Long-Term Care Planning Kit, which featured two elements:
  • A 28-page brochure describing what is and what is not covered by public programs related to long-term care. The brochure also describes several ways to plan ahead, addressing legal issues, assessing services and private financing options for long-term care.
  • An audio CD with interviews of persons engaged in different types of planning activities such as obtaining a reverse mortgage, making home modifications, or buying long-term care insurance.

The core components of the Campaign were a direct mail initiative and a media initiative. The direct mail component included a letter from the Governor of each state to every household with a member between the ages of 50 and 70. The letter included the tri-fold brochure described above as well as a toll-free number through which the Long-Term Care Planning Kit could be requested. Over 2.1 million letters were sent to households across the five pilot states. Follow-up postcards to remind those in the target group of the availability of the Planning Kit were also used.

The second component of the Campaign was a series of paid media spots to further publicize the toll-free number for ordering the Planning Kit. Paid media included television and radio spots selected to maximize exposure in the target audience of 50-70 year olds.

The core Campaign components outlined above were supported by a series of state-specific activities designed to take advantage of local resources and information dissemination opportunities. All these activities were directed at encouraging consumers to call or write to order the Long-Term Care Planning Kit.

The table below shows the mix of communications used in each of the Campaign states.

Campaign Results

Over all the Campaign states, the unduplicated response rate is 7.7%. While response rates were highest in Virginia (9.1%), in all states, the response rate meets or exceeds our baseline estimate of 5% which is considered an appropriate response rate for a social marketing campaign. These response rates are also significantly higher than comparable private sector direct mail campaigns (which might see responses of 0.5-2.0%). As mentioned earlier, New Jersey's response rate of 7.5% is especially impressive considering the fact that no paid television media was used there.

The Pilot Campaign had broad-based appeal. Interest in the Planning Kit was evident across all demographic groups. Specifically, there was little difference in the response rates across socio-demographic groups within or across the Campaign states. While interest in planning is evident across all the socio-demographic groups within the target population, the "typical" responder across all states is as follows:

• Age 58;
• Household income of $60,000-$75,000;
• A homeowner with a median home value of $130,000;
• Has some college education or more; and
• Over one-third of the responders are married.

In particular, the Campaign appears to have successfully reached the "Tweeners" -- those individuals of more moderate income and assets who have planning options but are potentially vulnerable to spend-down to Medicaid if they do not learn about and adopt such planning options. Differences in responder and non-responder profiles across states primarily reflect differences in the underlying target population in those states. No state-specific patterns were identified with respect to who responded and who did not respond to the Campaign messages.

Other key findings of the Campaign include the following:

• Public sector sponsorship of the Campaign is critical to achieving good response rates and ensuring consumer confidence in the objectivity of the information provided.
• Direct mail appears to be a more cost-effective communication vehicle than paid media. While it remains to be seen whether consumers exposed to the paid media are different in terms of their attitude or behavior change as a result of the Campaign, there was no significant difference in response rates between "media" and "non-media" states. Also, given the cost of paid media in most major media markets, direct mail is a more cost-effective and sustainable option, at least in terms of generating reasonable response rates.
• The Campaign helped raise awareness among state policymakers of the need for an integrated approach to fostering private responsibility for long-term care planning. Subsequent to the Campaign, two of the states have initiated activities to offer a long-term care insurance program for public employees and retirees.
• The Campaign has also renewed a collaboration between the public and private sectors with the unified objective of raising awareness and education on these critical issues.

Following the success of Phase I, HHS announced plans in July 2005 to initiate Phase II in order to enable additional states, selected through a competitive application process, to participate in the "Own Your Future" Campaign.

Additional information on the Campaign can be found at http://www.ltcaware.info.

Consumers can view or download the Long-Term Care Planning Kit at a newly created consumer information website found at http://www.aoa.gov/ownyourfuture/.