Evaluation of Selected Aspects of the National Medicare Education Program: Final Design Report. 1.2 National Medicare Education Program (NMEP)


CMS initiated the NMEP in 1998 to announce programmatic changes and to help Medicare beneficiaries make more informed health care decisions. The NMEP employs numerous channels to educate beneficiaries about their Medicare benefits; health plan choices; supplemental health insurance; beneficiary rights, responsibilities, and protections; and health behaviors. These channels include NMEP print materials like the annual Medicare & You handbook; toll-free telephone services like 1-800-MEDICARE; a CMS-sponsored Web site (http://www.Medicare.gov) that provides basic and comparative information on health insurance options and quality-of-care measures; a broad regional office education initiative called Regional Education About Choices in Health (REACH); the national alliance network; national training and support for information givers; and enhanced beneficiary counseling and other services from the State Health Insurance Assistance Programs (SHIPs) (CMS, 2007CMS, 2007). Following is a brief synopsis of each major NMEP activity directed by CMS.

Print Materials CMS provides a variety of print materialsincluding its flagship publication, the Medicare & You handbook to educate the beneficiary population about the Medicare program and health plan choices. CMS mailed the first Medicare & You handbook in November 1998 to more than 5 million Medicare beneficiaries in five pilot statesArizona, Florida, Ohio, Oregon, and Washington. A condensed Medicare & You bulletin was mailed to beneficiaries in the remaining 45 states and territories. CMS revised the handbook based on findings from the pilot test and, in 1999, mailed out the handbook nationally. Since that time, the handbook has been revised annually, incorporating changes based on beneficiary feedback and testing, consultation with low literacy experts, and feedback from lessons learned. Recent additions to the handbook include descriptions of patient rights and protections, preventive benefits, availability of health care options including Original Medicare and Medicare Advantage Organizations, and Prescription Drug Benefit (Part D) coverage. Medicare & You is available in English, Spanish, Braille, audiotape, and large print versions. It is mailed to new beneficiaries at the time of enrollment and, as mandated by the Social Security Act, to all beneficiaries annually. In addition to the national version, 26 area-specific versions also exist for designated regions.

In addition to the Medicare & You handbook, CMS publishes close to 40 topic-specific publications under the broad headings of (1)medical decision-making, (2)coverage and benefits, and (3)payment and rights. These materials discuss a variety of topics, including covered services, health care choices, supplemental health insurance coverage, Medicare rights and protections, and costs for specific services. As with the handbook, most publications are available in English, Spanish, Braille, audiotape, and large print versions.

Internet Activities In June 1998, CMS launched a Web site designed for beneficiaries ( http://www.medicare.gov/). The BBA of 1997 mandated that an Internet site be developed to provide accurate and reliable information to beneficiaries on Medicare basics, M+C plan comparison, and quality information to promote informed choices. Information on the site includes the Medicare & You handbook in printable format; general information about Original Medicare, Medicare Advantage plans, and Medicare Part D; a directory of Medicare participating physicians; lists of resources and telephone numbers for obtaining information about Medicare; and procedures to follow when filing Medicare claims or appeals. In addition, Web site users can order publications, search the site for specific content, and subscribe to a listserv that provides routine e-mail updates. The Web site also hosts several comparative databases:

  • Medicare Prescription Drug Plan Finder
  • Medicare Options Compare
  • Hospital Compare
  • Home Health Compare
  • Nursing Home Compare
  • Dialysis Facility Compare

Each of these databases allows individuals to compare their health plan options in a given area (by city, state, county, and zip code). The Medicare Prescription Drug Plan Finder allows Medicare beneficiaries and their caregivers to generate comparisons of Part D plans based on the beneficiary’s prescribed medications. Medicare Options Compare provides detailed comparisons of Medicare Advantage and other supplemental plans. Each of the other Compare sites contains publicly reported information about the services and quality of care provided at individual hospitals, home health agencies, nursing homes, and dialysis facilities.

Toll-Free Medicare Helpline 1-800-MEDICARE is a toll-free service available across the United States. The BBA of 1997 directed that a toll-free helpline be maintained to handle inquiries about beneficiaries’ benefits and available options under Medicare. CMS phased in the helpline between November 1998 and March 1999. The helpline operates 24 hours a day, 7 days a week, and is staffed by customer service representatives (CSRs) from 8:00 am to 4:30 pm. CSRs help answer general Medicare questions, provide information regarding health plan choices in a given area, process requests for plan comparison information and educational materials, and make referrals to other information sources when appropriate. Based on the complexity of questions, callers are directed to CSRs who can address increasingly difficult questions. Callers also have the option of using an automated response line to find answers to commonly asked questions or to request educational materials. Both CSR assistance and the automated response line are provided to callers in either English or Spanish. Also, a TTY line is available for the deaf and hearing impaired.

REACH Each of CMS’ 10 regional offices partners with community-based organizations to conduct educational outreach efforts at the regional, state, and local levels. Known as REACH, many of these activities are targeted to specific minority groups and beneficiaries with disabilities who are eligible for both Medicare and Medicaid. The BBA of 1997 required that each November, in conjunction with the annual health plan election period, a nationally coordinated educational and publicity campaign provide M+C-eligible individuals with information about health care plans and the election process. This outreach includes public presentations, exhibits at local health fairs, advertisements, radio talk shows, newspaper editorials, and other health-related events.

Enhanced Beneficiary Counseling from SHIPs SHIPs provide free, personalized health insurance counseling and assistance to Medicare beneficiaries through in-person meetings, telephone helplines, and group outreach and education. A SHIP Web site (www.shiptalk.org) also provides assistance to beneficiaries. These organizations are part of each state’s Office of Aging or Office of Insurance. Extensive training has been conducted with SHIP staff and volunteers to prepare them to help Medicare beneficiaries make informed decisions about their health care.

National Train-the-Trainer Program This program trains educators who work with CMS staff, partner organizations, and others who provide information, assistance, and education to Medicare beneficiaries. The focus of the program is to provide updated Medicare information to these intermediaries while enhancing their teaching and training skills. The training is provided in multiple formats, including videos, audio conference calls, Web casts, classroom presentations, resource kits, and quick-start guides. A Spanish-language training also is available for those educators and partner agencies that work with Spanish-speaking populations.

National Alliance Network CMS has enlisted national and local partners to support and participate in the NMEP. More than 200 national and local organizations that work on behalf of aged and disabled Americans are involved in this publicprivate partnership, including advocacy groups, health plan organizations, providers, employers, and unions. Together with CMS, these national partners reach out to other organizations at the state and local levels. They, in turn, educate Medicare beneficiaries and other interested organizations and individuals to help them better understand changes to the Medicare program. These education efforts include a Web site, print publications, forums, training sessions, public presentations, health fair exhibits, and other health-related events.

Employer Forum The Employer Forum is composed of employer members of the Washington Business Group on Health, Midwest Business Group Health Care Association, other employers, other interested organizations, and CMS staff. Participants in this Forum represent over 400 employers and more than 50 million employees. The Forum functions overall as a vehicle for an ongoing dialogue between the employer community and CMS, and an Employer Forum Conference Call is held monthly for 1 hour on the second Thursday of the month. This conference call was an outgrowth of CMS’ Employer-Union Conference conducted in March 2000, where the primary outcome was a strongly expressed desire by the employer community to continue an ongoing dialogue with CMS.

Health Outreach Initiative Zeroing In On Needs (HORIZONS) To ensure that information would be easily understood by various cultural groups, CMS launched the HORIZONS project in 1999 to improve communication with Medicare beneficiaries from diverse populations. These populations often have barriers to accessing information, such as language, location, or low literacy. Team members developed communication strategies targeted at four specific groups of beneficiaries: African Americans, Hispanics, Asian Americans and Pacific Islanders, and American Indians and Alaska Natives.

Part D and Other Educational Activities Since the MMA of 2003, fewer Medicare educational activities and materials have been formally labeled as being part of the NMEP campaign. Nevertheless, these activities continue to promote understanding of Medicare coverage options and often incorporate information about Part D and prescription drug coverage. At the same time, new educational activities have emergedsuch as the Welcome to Medicare brochure and the Part D prescription drug discount cardsthat were not part of the original NMEP program.

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