Content by Keyword: Medicare

A cha llenge for applying CEA to the NMEP is that different activities operate through different channels and may have different intended purposes. For example, the www.Medicare.gov Web site is not a direct substitute for the community outreach programs in the NMEP. Therefore, as a first step in conducting a CEA of the NMEP, one must identify a pr

The primary outcome for a CEA of the NMEP is an estimate of the cost per unit change in an outcome of interest (e.g., $5,000 per one-unit increase in the level of Medicare beneficiary knowledge for activity A, and $10,000 per one-unit increase in the level of knowledge for activity B). Given that the NMEP consists of five major activities, one cou

The proposed CEA will provide answers to the following research questions:

CEA is an economic evaluation tool designed to compare the relative costs and effectiveness of different policy mechanisms in achieving an outcome. When alternative policy instruments exist, CEA can be used to identify which policies achieve the largest outcome improvement at the smallest cost.

Although the prospective cohort study design is one of the most rigorous and appropriate designs for evaluating NMEP activities, it has several challenges. The five primary obstacles for the study include attrition, limited recall of NMEP activities, diminished recall of the decision process, limited decision points during the study, and difficult

The cohort study will measure multiple outcomes and variables that depict beneficiary decision-making processes and how these processes change over time. The variables are broken down below into two categories outcome measures and independent measures.

Data for the prospective cohort study will be collected at regular intervals and will include both quantitative and qualitative approaches. Two instruments could be used for primary data collection a more quantitative self-administered, mail-returned survey and a one-on-one telephone discussion guide to collect more qualitative information. The su

Several sample selection and study duration options are available for the prospective cohort evaluation. We recommend that potential participants be randomly selected from the Social Security Administration files and the Medicare enrollment database (to ensure some representation from those eligible for Medicare due to disability) and that partici

Because understanding beneficiaries’ decision-making processes is a primary objective for this study, we propose using a theoretical foundation that helps explain IDM the Elaboration Likelihood Model (ELM) (Petty and Cacioppo, 1986Petty and Cacioppo, 1986). The ELM suggests that individuals can use two different cognitive processes to make decis

The major advantage of this prospective cohort study is the ability to evaluate how Medicare beneficiaries’ enrollment status, plan satisfaction, and plan decisions change over time. By following beneficiaries from pre-enrollment (age 64) through the processes of initial enrollment, change-of-plan decisions, and, if applicable, disenrollment, we

A prospective cohort study is the most in-depth design option available for evaluating the NMEP, and this design has several advantages over other study options. First, the study will identify how key influences on Medicare decision making change over time. By following beneficiaries through the enrollment and plan decision processes, we can exami

The most likely challenge will be gaining the participation of employers and pharmacists. In our prior experience, human resources staff and benefit managers are extremely busy. We recognize that each group may be very busy depending on their business cycle. Therefore, it will be important to get on their calendars well in advance and to be clear

We recommend using a qualitative analysis software package (e.g., Atlas.ti) to file and organize the data. These activities include performing data reduction, creating data displays, and formulating and verifying conclusions drawn from the data.

We recommend purposeful sampling to select the nine employers, nine pharmacists, and nine SHIP programs for the case studies. Employers should be selected based on their size, kind of business, richness of retiree benefits, and location. Pharmacists should be selected to achieve geographic diversity as well as representation of large chains and sm

Research questions addressed through the case studies and the key informant interviews can provide insight into two main domains: 1. Beneficiary awareness, access to information, understanding, and enrollment experiences from the perspective of employers, pharmacists, and SHIP staff and 2. Employer, pharmacist, and SHIP staff awareness; access

Although the NMEP’s stated goals do not specify the role of employers, SHIP counselors, or pharmacists as potentially important information intermediaries for beneficiaries, we believe that a comprehensive evaluation of the NMEP should assess the perspectives and potential role of these stakeholders. Employers serve as a trusted source of inform

Using this data source presents two major challenges. The first is determining whether questions of interest have been asked over time so that trends and longitudinal analyses of interest can be conducted. The second (and most likely greater) challenge is adding questions to the survey. Adding questions requires approval from the survey administra