Medicare Modernization Act: Looking to the Future by Learning from Proven Best Practices

1. Medicare Modernization Act: Looking to the Future by Learning from Proven Best Practices Dr. James Firman President & CEO, National Council on Aging

2. Findings presented here are based on the combined experiences of NCOA, the Access to Benefits Coalition (ABC) and the Benefits Data Trust (BDT) to date • NCOA experience include: • Benchmarking studies related to key aspects of enrollment in the Extra Help available through Medicare Prescription Drug Coverage (identification; contact, screening and persuasion; enrollment) • Work with ABCs, a network of over 100 national members and 55 local/state coalitions in 36 states working to find Medicare beneficiaries with limited means and help them to apply for the Extra Help • My Medicare Matters campaign, a comprehensive, national education program helping people with Medicare understand the prescription drug coverage • ABC experience include: • Helping 90,000+ apply over past 6 months for the Extra Help • BDT experience includes: • LIS enrollment project in collaboration with Kaiser Permanente • 35,000 phone referrals for LIS application assistance from PhRMA call center • Initial pre-testing of national lists

3. Even across best practices, results can vary dramatically On-site events On-site outreach w. referral to phone enrollment center List outreach w. referral to phone enrollment center PR driving to phone enrollment center Note: Most projects were primarily enrolling beneficiaries in the Transitional Assistance (TA) $600 credit for the Medicare Prescription Drug Discount Card; 5 projects were enrolling beneficiaries in different benefits. The time period studied was generally 4-5 months. Source: Bridgespan interviews with the directors of specific outreach and enrollment projects, and analysis of data provided

4. Until now, the most costly part of the process has been finding and connecting with people likely to be eligible • Over half of the costs of getting people enrolled in benefits is locating those likely to be eligible. • Seniors who “self-identify” by calling a trusted source with questions about reducing drug costs are an excellent source of leads that can lead to low cost enrollments.  • Conversion rates are 4+ times greater for outbound calls of this type compared to unsolicited outbound calls. • 55% of total costs per enrollment relate to identification • Conclusion: By finding strategies that will lower costs of finding and connecting with people, total societal costs can be reduced significantly. 55% of costs

5. Using lists of those most likely to be eligible is one of the most promising approaches • By using lists to identify specific individuals who are highly likely to be eligible and contacting them directly, projects can dramatically lower their costs and reach more people • Projects that used lists had costs that were on average 40% lower than projects that did not Note: Some projects’ use of lists was more sophisticated than others (e.g. cross-referencing lists, testing mailings, etc.) Source: Bridgespan & NCOA outreach & enrollment benchmark study

6. A “person-centered” approach enhances results and is generally needed: Benefits are highly correlated with one another Source: BenefitsCheckUp

7. Implications for Future Funding Based on Key Best Practice Findings • The use of lists of likely eligible beneficiaries for targeted outreach and enrollment efforts is among the most promising, cost-effective and scalable approaches, and is necessary to maximize enrollment • Some of the key factors for reducing enrollment costs and increasing success include: • Well-executed phone-based enrollment • Using simple, yet sophisticated technology such as online eligibility tools and wireless Internet access • Careful planning of the method, frequency and format of contact • “Qualifying” leads by identifying those most likely to be eligible before beginning the enrollment process • A steady volume of qualified leads matched with an organization’s capacity • One-on-one assistance from trusted intermediaries • Building the ability to track, analyze and learn from results is key to continued success in enrollment efforts.

8. Questions