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HCFA's Plan of Action*
What HCFA Will Do in 1998
The Health Care Financing Administration's (HCFA's) Center for Beneficiary Services views 1998 as an "awareness year." By effectively using the national and local media, large national organizations such as the American Association of Retired Persons, and the 10 regional HCFA offices, HCFA intends to undertake a large publicity and education campaign called the National Medicare Education Program (NMEP). NMEP has three goals:
- beneficiaries should be able to access information when they want it;
- beneficiaries should understand the information needed to make informed choices; and
- beneficiaries should perceive that NMEP, HCFA, and the federal government and its partners are trusted and credible sources of information.
Recognizing the 5–year implementation challenge that it faces under the provisions of the Balanced Budget Act of 1997 (see the box What Must Be Done Under the Statute), HCFA will not be able to develop cohesive, locally targeted, or elegant approaches to information dissemination in year one. Rather, HCFA is taking a long-term view of the information dissemination process and the need to develop a better understanding on the part of beneficiaries of the basic Medicare program and the Medicare+Choice program.
HCFA, however, will be striving in the first year to provide beneficiaries and intermediaries who disseminate information with accurate and timely information so that those beneficiaries who choose to participate actively in Medicare+Choice will not suffer from a lack of information designed to assist them in choosing a health plan.
Building a Knowledge Base With Better Information Dissemination
HCFA states that it will take the full 5 years stipulated in the Balanced Budget Act of 1997 to attain good beneficiary understanding of the Medicare+Choice process. To achieve this goal, HCFA proposes to undertake a broad public education campaign. By layering the kind of information disseminated to the public into basic, detailed, and special-case information, HCFA hopes both to provide beneficiaries with a better sense of how the program operates and to assist
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What Must Be Done Under the Statute Beginning in 1998, Congress required HCFA to provide all Medicare beneficiaries with the following information:
For the coordinated care options (health maintenance organizations, preferred provider organizations, provider sponsored organizations, etc.), HCFA must explain each plan's:
HCFA must use the following methods to convey information to the beneficiaries:
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them in better understanding the implications of their health plan choices. HCFA will undertake a Special Information Campaign beginning in the fall of 1998. The goal of this campaign will be to inform those eligible for Medicare+Choice of the existing plan options and the plan selection process. The 10 regional HCFA offices are charged with developing the specific action plans for their regional, state, and local information and outreach efforts.
Recognizing the diversity of the Medicare population, HCFA plans to tailor its information for different communities within the Medicare population. In 1998, information tailoring will be limited to the publication of English- and Spanish-language versions of the required information because HCFA does not possess the resources to provide information in every language spoken in the United States and does not anticipate that it will have the resources to do so even at the end of the 5–year implementation period (see Chapter 7 for a discussion of language barrier issues).
By using existing private-sector call center technology, HCFA plans to develop state-of-the-art telephone call centers, toll-free telephone numbers, and information on a site on the World Wide Web in line with the Balanced Budget Act's requirements. As outlined at the workshop, HCFA plans to develop a customer-service telephone line to provide beneficiaries with information on Medicare+Choice and plan options. Beneficiaries will be able to speak directly with a customer service representative, if they so choose. The agency will supplement the customer service telephone line with printed information. As experience with the system grows and answers to questions are standardized, HCFA hopes that it will be able to automate the means of accessing more of the information and ultimately reduce the cost of maintaining the call center and toll-free telephone number. Beginning in the fall of 1998, HCFA will have 600 customer service representatives at four call center sites available to assist beneficiaries.
According to HCFA, 7 percent of all Medicare beneficiaries have access to the Internet. The agency's web site for Medicare+Choice, www.Medicare.gov, launched in the spring of 1998, includes information on program benefits, health system performance, health plan choice, and health promotion information. A valuable tool located on the web site is the Medicare Compare database. This feature enables beneficiaries to locate information on plans' benefits and premiums by zip code. HCFA expects to add to this database comparative information on health plan quality by the end of 1998. HCFA plans to update the database quarterly.
Experts on the potential of the Internet to educate consumers make the point that this medium allows consumers to access the specific information that they need within larger databases. Good Internet sites also allow consumers to link to other, related areas and sites from a central location (Cronin, 1998).
Relying on the Community for Assistance
In an effort to build national and community-based partnerships, HCFA is creating the Alliance Network, which consists of about 100 national, state, and local organizations that serve as channels of information on Medicare+Choice program activities and materials. By working with large employer groups that have Medicare populations, other government entities that work with this population, numerous community organizations, and information and counseling assistance programs, HCFA hopes to use each group's best practices to develop a high-quality information infrastructure. The Alliance Network will have three layers:
- a coordinating committee that acts as the national leadership for NMEP; the committee will provide high-level support to HCFA in the creation of educational materials;
- task force members who will actively disseminate NMEP materials and communicate information about the program; and
- educational affiliates, which will be organizations and agencies that distribute Medicare+Choice information to their members or clients.
Over the long-term, HCFA will be working closely with the Agency for Health Care Policy and Research and other groups to develop a common consumer information framework. Ideally, this collaborative effort will produce a standardized information framework that will enable health care consumers across the age spectrum to look at information in the same standardized format with identical terms and definitions. The end result of this effort will be an information framework that does not change as an individual moves from employer-based health care into Medicare.
