Evaluation of Selected Aspects of the National Medicare Education Program: Final Design Report. Previous NMEP Evaluations

01/10/2008

There are many important reasons to invest in future comprehensive evaluations of the NMEP, particularly as this program continues to evolve (and in some cases expand) to meet the changing information needs of Medicare beneficiaries. Since 2003, the focus of NMEP has appeared to shift with the MMA and the introduction of the Medicare Part D program. More recent studies have focused less on what has traditionally been defined as NMEP and more generally on beneficiary education or Part D education, specifically. Many of the Part D -focused activities, such as reliance on a 1-800-MEDICARE hotline to disseminate information on prescription drug options, are essentially significant expansions of original NMEP modelsmodels that often received only minimal evaluation. In addition, federal appropriations for NMEP include monies for traditional NMEP activities as well as MMA beneficiary education. This evolution toward more prescription drug issues may make it difficult (particularly with declining agency resources) to focus on the broader set of Medicare education topics that had historically been the focus of the NMEP, such as awareness of insurance option choices and managed care.

Given these issues, and the fact that the Medicare program has changed significantly in just the last few years, it is even more critical that beneficiaries are knowledgeable about the Medicare program and have the resources and support they need to make informed decisions in this changing environment. The NMEP is a critical part of an overall effort to educate Medicare beneficiaries and other stakeholders about the program so that health and health care decisions can be informed. This is consistent with other changes in the health care system that now require greater participation by consumers and patients in the decision-making process. It is likely that this expectation for involvement will continue to grow, placing greater responsibility on beneficiaries and their families. Poorly informed decisions could not only have a negative health impact on beneficiaries, but also end up costing the Medicare program more money in the long run.

Significant financial resources have been, and continue to be, invested in the NMEP. Activities that build on original NMEP activities, aimed at meeting the expanding information needs of beneficiaries for use of programs such as Part D, should ensure that only effective education initiatives are expanded and that ineffective and/or inefficient initiatives are modified (rather than perpetuated). Information is sorely needed about the return on these NMEP investments. Cost assessments can examine where there are efficiencies and inefficiencies in the program and where resources can be directed to affect the larger number of individuals. For these reasons, continuing to monitor and evaluate NMEP has increasing policy importance.

Evaluations of the NMEP should assess the effect of the progr am from multiple perspectivesthat of beneficiaries and their families; Medicare providers; and stakeholders such as employers, CMS partners, and policy makers. In doing so, the evaluation must be comprehensive in nature and will mostly likely require a mixed-method approach. To adequately measure the impact of the evaluation over time on key variables of interest, an evaluation should have a longitudinal component and rigorous analysis of the resulting data. This type of evaluation can help us learn whether the program is meeting the informational needs of its constituents and if it is successful in facilitating access to high-quality health care for those who are eligible.

We conducted an environmental scan to inventory, review, and summarize materials describing and evaluating all of CMS’ current and past NMEP activities.

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