Evaluation of Selected Aspects of the National Medicare Education Program: Final Design Report. Conclusions


The goal of this project was to identify opportunities and approaches for future comprehensive evaluations of the NMEP program. Future evaluation options should build on extensive existing research on the NMEP. P revious evaluations have predominantly assessed (a) beneficiaries’ knowledge of Medicare and Part D; (b)beneficiaries’ awareness of the various NMEP components; (c)the appropriateness of information provided through various components to help beneficiaries understand their choices; and (d)beneficiaries’ use of and satisfaction with NMEP components. These evaluations have contributed to improvements in the NMEP programs.

Despite these evaluations, some NMEP activities have not been thoroughly assessed, and several critical questions about the program are still unanswered. To date, few evaluations have examined what knowledge beneficiaries need to make informed enrollment decisions, to what extent NMEP activities promote IDM, and what the return on the considerable investment is for such activities. These are crucial questions because, as the Medicare program continues to expand and change, the NMEP and other activities based on original NMEP models likewise continue to expand. Beneficiaries will become increasingly reliant on educational tools and materials in making enrollment decisions. Evaluating the NMEP in a comprehensive, systematic, and ongoing manner will ensure that the program is as effective and cost-efficient as it needs to be to support beneficiaries.

Thus, additional opportunities for evaluating the NMEP definitely exist. Prior NMEP research suggests that what is most lacking among these previous evaluations is an indication of whether the NMEP has led to change in the beneficiary population, particularly whether beneficiaries (a)are more aware of their Medicare choices; (b)better understand and have improved knowledge of their choices; and (c)make informed health care choices at all and/or over time. Finally, little emphasis has been placed on evaluating the relative impact and cost-effectiveness of various NMEP activities in previous evaluations.

Based on this identification of opportunities for future research, in consultation with ASPE and our project consultant, we identified and further developed four specific options for ongoing NMEP evaluation activities. A summary of the pros and cons of these options are summarized in Table 5-1.

Design Option



Table 5-1. Pros and Cons of Recommended Design Options

 Longitudinal Analysis of MCBS

  • Existing, well-designed longitudinal survey representative of beneficiary population

  • Less expensive than fielding a separate survey

  • Limited or no ability to add questions

  • No control over how new questions are asked or how many times questions are administered over time

Case Studies of Employers, Providers, and SHIPs

  • Assess the perspectives of stakeholders important information intermediaries for beneficiaries

  • Does not currently align with the stated goals of the NMEP

Prospective Cohort Study of Beneficiaries

  • New contribution

  • Ability to measure multiple outcomes longitudinally

  • Questions can be augmented over time to correspond to changes in the goals/direction of the NMEP

  • Could be relatively costly depending on final design and sample size

Cost-Effectiveness Analysis

  • New contribution

  • Ability to obtain necessary cost data

  • Chosen outcome should directly link to the program (such as exposure or program reach). If the outcome is less direct (behavior change), the analysis is complex because of other factors that may have influenced the behavior

  • CEA should follow assessment of program effectiveness and be conducted only if the program is determined to be effective

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