The MCBS can answer the following research questions, addressing various dimensions of an evaluation of the NMEP: access to NMEP information, understanding of Medicare, understanding of NMEP information, use of the NMEP, and disparities between groups in outcomes of interest.
1. Do beneficiaries have access to information from Medicare when they need to make changes in their benefits or coverage? What source(s) of information do beneficiaries have access to? Is access to information increasing over time?
2. Do beneficiaries understand Medicare’s features and options? Does beneficiary understanding improve with longer tenure in the program? Is beneficiary understanding of the program’s features and options increasing over time? Is use of particular NMEP interventions or combination of interventions related to greater understanding of the Medicare program?
3. Do beneficiaries understand the information they receive, can they use it to make informed decisions if they so desire, and is the level of beneficiary understanding changing over time?
4. Are beneficiaries using NMEP information to make choices and is use of the information increasing over time? Which sources of information are beneficiaries using? Are beneficiaries using one or more NMEP sources of information and has the selection of choices changed over time? Are non-NMEP information sources also important sources of information for beneficiaries? Is use of particular NMEP interventions or combination of interventions related to greater awareness and knowledge of key Medicare program concepts or new prescription drug features?
5. Do research question outcomes differ by whether a beneficiary experienced a change in circumstances necessitating a change in coverage (e.g., new enrollee, retirement, relocation, plan elimination), beneficiary age, gender, race, urbanicity, or use of medical services? Do research question outcomes differ among beneficiaries who make their own decisions, those who receive assistance, and the helpers of beneficiaries who cannot make their own decisions?
Some of these questions have been addressed in earlier evaluations, providing historic answers to the research questions. (Our earlier Task 3 literature review provides a summary of methods and findings from earlier evaluations.) A new evaluation can extend earlier findings, as well as provide answers to new questions. Table 4-1 maps the research questions to potential MCBS survey questions, indicating whether the questions have been asked previously or are new. Because of space limitations, questions that have been fielded previously through the MCBS are paraphrased in the table, followed by their related MCBS survey item number. The exact survey questions are included in Appendix B .