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Medicare Drug Program
Poor Communications on Medicare Drug Plan May Be
Reason Enrollment Lags
GAO tells CMS to improve hotline and Website
May 4, 2006 – With the deadline (May 15) for
enrolling in the first year of the Medicare drug program rapidly
approaching, the Government Accountability Office may have found the
not-very-surprising reason many senior citizens have not enrolled – the
communications about the program have not been very good. The Centers for
Medicare and Medicaid Services said it is taking action to make the
suggested improvements, although the agency said the findings were not a
complete and accurate picture.
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The GAO recommend that the CMS enhance the quality
of its communications by taking actions to improve written materials,
its 1-800-MEDICARE help line, and the Medicare Web site.
On January 1, Medicare began providing coverage for
outpatient prescription drugs through its new Part D benefit.
Beneficiaries who enroll in Part D may choose a drug plan from those
offered by private plan sponsors under contract to the Centers for
Medicare & Medicaid Services (CMS), which administers the Part D
benefit. Beneficiaries have until May 15, 2006, to enroll in the Part D
benefit and select a plan without the risk of penalties.
GAO was asked to review the quality of CMS’s
communications on the Part D benefit. GAO examined 70 CMS publications
to select 6 documents for review and contracted with the American
Institutes for Research to evaluate the clarity of these texts; made 500
calls to the 1-800-MEDICARE help line; and contracted with the Nielsen
Norman Group to evaluate the usability of the Medicare Web site.
The information given in the six sample documents
that GAO reviewed describing the Part D benefit was largely complete and
accurate, although this information lacked clarity.
The documents were unclear in two ways.
First, although about 40 percent of seniors read at
or below the fifth-grade level, the reading levels of these documents
ranged from seventh grade to postcollege.
Second, on average, the six documents did not
comply with about half of 60 common guidelines for good communication.
For example, the documents used too much technical jargon and often did
not define difficult terms, such as formulary.
Moreover, 16 beneficiaries and advisers that GAO
tested reported frustration with the documents’ lack of clarity and had
difficulty completing the tasks assigned to them. Although the documents
lacked clarity, they informed readers of enrollment steps and factors
affecting coverage decisions and were consistent with laws, regulations,
and agency guidance.
Customer service representatives (CSR) responded to
the 500 calls GAO placed to CMS’s 1-800-MEDICARE help line accurately
and completely about two-thirds of the time.
Of the remainder, 18 percent of the calls received
inaccurate responses, 8 percent of the responses were inappropriate
given the question asked, and about 3 percent received incomplete
responses. In addition, about 5 percent of GAO’s calls were not
answered, primarily because of disconnections.
Accuracy and completeness rates of CSRs’ responses
varied significantly across the five questions GAO asked. For example,
while CSRs provided accurate and complete responses to calls about
beneficiaries’ eligibility for extra help 90 percent of the time, the
accuracy rate for calls concerning the drug plan that would cost the
least for a specified beneficiary was 41 percent.
For this question, the CSRs responded
inappropriately for 35 percent of the calls by explaining that they
could not identify the least costly plan without the beneficiary’s
personal information—even though CSRs had the information needed to
answer the question.
The time GAO callers waited to speak with CSRs also
varied, ranging from no wait time to over 55 minutes. For 75 percent of
the calls—374 of the 500—the wait was less than 5 minutes.
The Part D benefit portion of the Medicare Web site
can be difficult to use, said the GAO report.
GAO’s test of the site’s overall usability—the ease
of finding needed information and performing various tasks—resulted in
scores of 47 percent for seniors and 53 percent for younger adults, out
of a possible 100 percent.
While there is no widely accepted benchmark for
usability, these scores indicate that using the site can be difficult.
For example, the prescription drug plan finder was complicated to use
and some of its key functions, such as “continue” and “choose a drug
plan,” were often not visible on the page without scrolling down.
For the full report click -
www.gao.gov/cgi-bin/getrpt?GAO-06-654
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