The Role of ABC in Medicare Part D

1
The Role of ABC in Medicare Part D

• Jim Firman
• President and CEO, NCOA
• Chair, ABC Steering Committee
• ABC Preconference Intensive
• March 9, 2005

2
Agenda

• Access to Benefits Coalition overview
• ABC plans for Part D

3
The Access to Benefits Coalition

• The Access to Benefits Coalition (ABC) was formed
  in 2004 to maximize enrollment of Medicare
  beneficiaries with low incomes in the Medicare
  Prescription Drug Benefit and other public and
  private programs that can help them pay for
  prescription drugs.
• Our experience with enrollment in the
  Transitional Assistance program informs our plans
  and strategies for the Low Income Subsidy and
  Part D education enrollment.

4
ABC Accomplishments in 2004

• In 2004-5, ABC helped more than 100,000
  beneficiaries reduce their prescription costs
  
• Created a nationwide infrastructure that is
  ready, willing and able to turn to Part D
  
• 98 national ABC partners
• 57 local or Statewide Coalitions in 37 States,
  representing hundreds of community-based
  non-profit organizations
  
• Enhanced and created new ABC technology tools to
  make the enrollment process more efficient and
  more likely to close the deal.

5
Important lessons from the TA experience will
inform Part D efforts

• To be successful in Part D, there needs to be
  much better coordination of public and private
  sector efforts
  
• Most beneficiaries want and need help from
  trusted local intermediaries that can spend time
  one-on-one to help them make decisions and
  enroll
• In-reach the use of existing public and private
  lists to target efforts to those most likely to
  be eligible can be a very cost-effective
  complement to traditional outreach strategies
• Community-based organizations can most
  cost-effectively enroll beneficiaries when
  likely-eligible consumers are driven to them
  through in-reach strategies or media stories
• Intermediaries and consumers need a variety of
  cost-effective decision-support and enrollment
  tools to achieve results. There is no
  one-size-fits-all
• We are in the process of completing a major
  benchmarking effort of promising practices to
  inform a Report to the Nation on maximizing
  enrollment in Medicare Part D in May 2005

6
ABC is now turning its focus towards maximizing
enrollment in Medicare Part D subsidy programs

• The 57 ABC projects provide a rich set of data on
  the most effective and efficient methods for
  outreach and enrollment
  
• Non-ABC efforts are also being studied
• Across the set, a wide range of strategies are
  being explored to find best practices
  
• These findings will be presented and publicized
  in a Report to the Nation on maximizing
  enrollment in Medicare Part D in May 2005
  
• Successful and most cost-effective enrollment
  practices
  
• Best approaches for specific target audiences
• Most appropriate roles for key players
• ABCs strong relationships with government
  officials and knowledge about best practices will
  help maximize the number of people enrolled.

7
ABC intends to partner with CMS, SSA and AoA to
maximize enrollment by public and private sectors

• ABC will complement and supplement CMS, SSA and
  AoA efforts, including
  
• High level planning and coordination of efforts
  to ensure maximum leveraging of resources
  
• Information-sharing about promising practices,
  cost-effectiveness and results to maximize
  learning
  
• Integrated software links to facilitate
  information-sharing, decision-support and
  enrollment
  
• ABC will also provide technical assistance,
  training, and decision-support and enrollment
  tools to increase the capacity of federal and
  state subcontractors/grantee organizations and
  other non-profits to help them cost-effectively
  find and enroll Medicare beneficiaries with low
  incomes

8
ABC will strengthen and support a nationwide
network of local and state coalitions

• ABC local, state and national members will find
  and enroll beneficiaries in the Part D low-income
  subsidy
  
• ABC will continue to support a nationwide network
  of local and state ABC coalitions by
  
• Providing technical assistance and training on
  cost-effective strategies
  
• Providing decision-support and enrollment tools
  to help facilitate enrollment
  
• Driving qualified leads to local enrollment
  centers through expanded use of inreach
  strategies
  
• Providing grant support for enrollment
  activities
  
• Encouraging local and regional foundations and
  corporations to invest in local ABCs
  

9
ABC will refine and more widely distribute Part D
decision support and enrollment tools

• ABC is developing a Part D decision-support and
  enrollment service which will include
  
• Recommendations about the best combination of
  Part D, state pharmacy assistance programs and
  company PAPs for each person
  
• On-line enrollment and/or e-forms for Part D
  subsidies, state programs and company PAPs
  
• Current eligibility rules and enrollment forms
  for Part D, the state pharmacy assistance
  programs and the company PAPs
  
• These tools will be made widely available to
  states, area agencies on aging, SHIPs and
  national and local ABC members at no cost
  
• ABC tools will also be available to consumers and
  their caregivers through accesstobenefits.org and
  through the Web sites of national and local ABC
  members

10
ABC will continue to foster and diffuse
innovations that produce improved outcomes

• ABCs national staff will continue to work with
  ABC Coalitions and others to
  
• Foster innovative community-based strategies to
  overcome barriers, improve processes and results
  
• Measure the cost-effectiveness of promising
  interventions and assess their potential
  scalability.
  
• Develop the art and science of in-reach
• Provide technical assistance and training to
  diffuse evidence-based innovations
  
• Advocate for federal and state actions that can
  lead to better results.

11
Summary of second year ABC plans
Maximize Part D enrollment among low-income
seniors
Provide tools to help increase effectiveness of
enrollment efforts
Advocate for support from policy officials

• Partner with CMS, AoA and SSA to develop and
  support a coordinated public-private strategy
  
• Foster and support outreach and enrollment
  efforts by ABC members and coalitions
  
• Directly enroll at least 100,000 people in Part D
  subsidies
  
• Provide technical assistance, training and tools
  to other non-profit organizations

• Develop and deploy Part D decision-support and
  enrollments tools
  
• For consumers and intermediaries
• Embedded in as many other web sites as possible
• Continue to foster innovations, benchmark
  promising practices and disseminate
  evidence-based strategies
  
• To ABC members
• To federal agencies and their grant recipients

• Continue to be a national voice for the value of
  the low-income benefits with the media.
  
• Continue to advocate with federal and state
  policymakers for actions that will maximize
  enrollment

12
Medicare beneficiaries with low incomes need our
help!

• It will take all of us working together to
  maximize the number of beneficiaries that sign up
  for Part D low-income subsidies.
  
• Get involved in state agency work groups
• Get involved in your local ABC coalition
• Contact information can be found at
  www.AccesstoBenefits.org