Lessons Learned: ABC’s Experience in Helping Beneficiaries with Low Incomes

1. Lessons Learned: ABC’s Experience in Helping Beneficiaries with Low Incomes Marisa Scala-Foley Associate Director, ABC Joint Conference on Aging March 9, 2005

2. The Access to Benefits Coalition (ABC) includes hundreds of nonprofit organizations across the nation that share a commitment to helping Medicare beneficiaries with lower incomes find the best combination of public and private prescription savings programs they need to maintain their health and improve the quality of their lives. ABC is working to find prescription drug savings for those who need them most

3. Create a nationwide infrastructure that will maximize the enrollment of lower income seniors in the Transitional Assistance program and in related benefits in 2004-2005, and in Part D benefits in the longer term By the end of 2008, at least 8 million lower-income beneficiaries will have enrolled in Medicare Part D low-income subsidy programs By 2012, at least 12 million will have enrolled ABC Objectives

4. ABC works in hundreds of communities across the nation and on the Web • ABC includes 98 national members, and hundreds of local, community-based nonprofit organizations in 57 communities in 37 States. • 57 Local and Statewide ABC Coalitions target the most populated cities, rural and suburban areas (see map) • ABC members are trusted, credible grassroots resources that provide 1-on-1 counseling, education, and enrollment assistance to Medicare beneficiaries with lower incomes to help them find the assistance that they need.

5. 57 ABC Coalitions Nationwide

6. ABC’s trusted on-the-ground resources coupled with web-based technology “closes the deal”

7. ABC Decision Support Tools ABC decision-support tools: • www.accesstobenefits.org • BenefitsCheckUpRx, version 2.0 • Simplified Medicare Card Finder • Seamless on-line enrollment through CMS online Enrollment Center • on-line access to hundreds of application forms • E-forms (fillable PDFs)

8. Lessons learned: Barriers to enrollment • Once a consumer forms negative attitudes, it is difficult to convince them to take action: • For example, research shows that many lower-income Medicare beneficiaries were: • Confused • Not very impressed with $600 savings • Not convinced the benefit is worth applying for • Skeptical about the new benefits –Don’t believe that that they will qualify and/or get them • These attitudes formed despite the fact that, by selecting the right card, the average Medicare beneficiary will actually save about $2,100 in 2005

9. Lessons learned: Finding and enrolling beneficiaries • Finding and enrolling low-income Medicare beneficiaries is time-consuming and hard work! • Outreach and education only goes so far…low-income consumers often need a great deal of hands on assistance to make decisions and to complete and submit application forms. • To be successful, we need trusted local intermediaries that are ready, willing and able to spend time one-on-one with beneficiaries to help them make decisions and to enroll.

10. Lessons learned: Tools and technology • Intermediaries and consumers need a variety of decision support and enrollment tools to make their jobs easier and to address individual needs and circumstances. Intermediaries should be empowered to use whatever tools and approaches will work best for them and their clients.  • We should maximize the use of technology. Integrated systems can play a critical role in quick and efficient enrollment of beneficiaries into prescription savings programs. (List strategies, decision support tools, online enrollment, pre-populated application forms.)

11. Lessons learned: “In-reach” • In-reach – the use of existing lists of low-income program enrollees – can be as important, if not more important, than traditional outreach strategies for reaching eligible beneficiaries. Both the public and private sectors have helpful lists. • Community-based organizations can most cost-effectively enroll beneficiaries when “likely-eligible” consumers are “driven” to them through list-driven/in-reach strategies or media stories.

12. Lessons learned: Social marketing and messages • We need to find the right mix of awareness building, education, decision-support and enrollment. • We need clear and compelling messages that motivate consumers to take action. • Even the most targeted messages will attract consumers who are not eligible for the subsidies…strategies are needed to help them as well. • We need coordinated distribution of messages by public and private sectors through a wide variety of channels and venues.

13. Building an evidence base • We need an evidence base about cost effective strategies for finding and enrolling beneficiaries • There is much that can be learned from the ABC and other experience during this interim period • Others include CMS/Ogilvy subcontractors, SHIPs, Medicare Today and more • With funding from Atlantic Philanthropies, ABC and The Bridgespan Group are working together to benchmark the most cost-effective strategies for community-based outreach, education, decision support and enrollment strategies • End result: Development and dissemination of “Report to theNation” on Maximizing Low-income Enrollment in Medicare Part D

14. Join us • Help us get the word out to Medicare beneficiaries with lower incomes that there are ways to save money on prescription drugs, right now! • Get to know your local ABC Coalition. • BenefitsCheckUpRx and Medicare Card Finder are on the Web and are available to anyone, anywhere, anytime! • Let’s look to the future and figure out ways to work together on Medicare Part D enrollment.