Medicare Part D: Reaching Out to Low Income Populations

1
Medicare Part D Reaching Out to Low Income
Populations

• Access to Benefits Coalition Ohio Chapter
• Kathleen Gmeiner, JD, MHSA
• NCOA-ASA Joint Conference
• March 15, 2006

2
Ohio Geography and Demographics

• Ohio Area Agencies on Aging

• Source Ohio Department of Aging,
  http//www.goldenbuckeye.com/aaa.html

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Ohio Demographics (continued)

• Population 11,421,268 (2002)
• White 83.8
• African American 11.5
• Hispanic or Latino 2
• Asian 1.4
• American Indian 0.2
• Native and Pacific Islander 0.02
• Two or more races 1.1
• Source U.S. Bureau of the Census, 2002 estimates

4
Ohio Demographics (continued)

• Population 65 and older 13.3 (2002)
• Population below 100 Federal Poverty Level
  10.6 (2000)
• Population below 200 Federal Poverty Level
  26.4(2000)
• Percent eligible for Medicaid 15.7 (State
  Fiscal Year 2002)
• Source U.S. Bureau of the Census (age,
  poverty) Ohio Department of Job and Family
  Services (Medicaid)

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Externals that Must Be Present to Promote
Application

• A product that people want
• Target audience must be ready
• Information well-known about the product
• Barriers to purchase must be minimal

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Externals (continued)

• You Need A Product People Want to Buy
• Summer of 2005 Medicare Prescription Drug Benefit
  Not Well Understood
• The LIS was disconnected from the product
  prescription drug coverage

7
Externals (continued)

• The Target Audience Must Be Ready
• During Summer 2005 January 1st seemed far off
• What people had heard about Medicare Part D made
  them suspicious rather than interested
• Many low-income Medicare beneficiaries had found
  a way to meet their prescription drug needs
  through Pharmaceutical Manufacturer Assistance
  Programs (PAPs), physician samples, discount
  cards or meeting their Medicaid spend-down.
• At recent enrollment events (February 2006)
  audience stayed after and asked questions. They
  are ready.

8
Externals (continued)

• Information Must Be Well Known About the Product
• Trusted sources, such as family members,
  pharmacists and physicians were not aware of LIS
  or its importance
• Media was not talking about it

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Externals (continued)

• Barriers to purchase must be minimal
• The need to disclose personal financial
  information for Extra Help was a barrier
• The paper application without media prep was a
  barrier
• Not personalized (letter and application all part
  of same booklet)
• Blends in with junk mail
• Too long

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• Ohios Experience

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Ohios Experience
BCU Statistical Reports ABC Ohio Chapter.
Includes comprehensive screenings, LIS
QuickScreen and Screenings for People with
Medicare and previous versions of Rx screenings.
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Our Experience (continued)

• June-August 2005
• Event-Focused
• Participating with Social Security Partners at
  LIS events
• Partnering with law students and Life Care
  Alliance to help sign people up at senior
  centers/residences
• Dept of Aging partner in libraries and other
  venues to explain LIS
• OASHF 20 educational events

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Our Experience (continued)

• September-October, 2005 (Event/Phone-focused)
• 33 events 4125 educated/contacts made
• 407 individual sessions
• 276 people assisted with applying for Extra Help
• Attend Commodity Supplemental Food Distributions
• throughout Southern and Central Ohio
• November, 2005 (Phone focused)
• 446 people educated
• 652 individualized sessions
• 186 assisted with Extra Help application
• These reported numbers do not include the Ohio
  Dept of Aging because they do not share in our
  funding stream, but their statistics are reported
  with the rest of the ABC-Ohio Coalition on BCU
  and they are included in the graph above.

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Our Experience (continued)

• December, 2005 (Phone focused)
• 19 events 284 people educated
• 486 individual sessions
• 165 helped to enroll in Extra Help
• 275 helped to enroll in Prescription Drug Plans
• January, 2006 (Phone focused)
• 187 individual sessions
• 161 helped to enroll in Extra Help
• 70 helped to enroll in Prescription Drug Plans

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Enrollment Drivers

• CSFP Build contacts and trust across wide
  geographical area with targeted audience
• Telethon
• November 15, 2005TV 10 Columbus10 county
  market
• 6 phones
• 2 hour shifts
• 6.5 hours
• 450 calls approximately one-half required
  call backs
• March 9, 2006
• 6 phones
• 1.5 hours total
• 104 calls

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Enrollment Drivers(continued)

• Working lists of previous callers
• Partner Council for Older Adults of Delaware
  County has found
• Ashland County Council on Aging

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Enrollment Drivers (continued)
Columbus Market Cincinnati Market Cleveland
Market 6 educators manager per market One event
per day per market
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Enrollment Drivers

• Strengthening Ohios Advocacy Network
• Put ABC funding into 7 organizations over 18
  months
• Held approximately ten training of professionals
  events
• Convened monthly state-wide phone calls with
  partner AARP
• Strong ABC Coalition with 30 partners, convened
  by Ohio United Way, nurtured through monthly
  meetings and frequent information sharing via
  e-mails (about 5/week)
• Led by forward-thinking agency, Ohio Association
  of Second Harvest Food Banks
• Sought and attracted additional funding
• Substantial sharing of information and funding
  across organizational lines

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Seeing Results
1 Data from Social Security Administration
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Messages Facilitating Enrollment

• We continue to point out topeople that this is
  not welfare but the governments way of
  addressingthe rapid increase in drug prices so
  that all can afford drugs. Once youget past this
  point, they are more receptive to completing
  theapplication. --Ohio Department of Aging Staff

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Challenges Remaining

• Estimated Eligibles
• 348,000
• Enrolled in Extra Help
• 53,010
• Number of persons aged 65 and older with income
  between 75 and 150 of the Federal Poverty
  Level
• 198,887
• Find the other 145,877 potential eligibles
• U.S. Bureau of the Census, STF 3, PCT 50

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Challenges Remaining (continued)

• Telethon brings eligible people out of the
  woodwork, but My Medicare Matters one on one
  assistance continues to be undertutilized.
• Decrease in funded outreach workers in Ohio
• Failure to resolve the issues between PhRMA and
  the Office of Inspector General regarding the
  availability of Prescription Assistance Programs
  (PAPs) is a barrier to enrollment by those who
  fear losing their prescription drugs.
• Unaffordable co-pays for Dual Eligibles and LIS
  make the LIS less desirable for those getting
  prescriptions through PAPs with no co-pay.

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Next Steps

• Build five key My Medicare Matters events in
  Appalachia
• Seek broader/deeper partnership with media to get
  to the remaining potential LIS eligibles
• Increase use of volunteers training new ones for
  phone banks and utilizing present ones to go into
  counties with unaddressed need
• Consistent grass-roots work to increase
  utilization of My Medicare Matters
• Greater engagement with the faith communities
• Test some new pilots to reach the hard-to-reach
  beneficiaries

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• If you wish to contact the author she can be
  reached by e-mail at kgmeiner_at_columbus.rr.com
• To contact the Ohio Association of Second Harvest
  Food Banks, call [phone].
• Executive Director Lisa Hamler-Fugitt