The Role of ABC in Medicare Part D Jim Firman President and CEO, NCOA Chair, ABC Steering Committee ABC Preconference Intensive March 9, 2005
Access to Benefits Coalition overview ABC plans for Part D Agenda
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. The Access to Benefits Coalition
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.”
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
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 • ABC’s strong relationships with government officials and knowledge about best practices will help maximize the number of people enrolled.
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
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 ABC’s
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 PAP’s for each person • On-line enrollment and/or e-forms for Part D subsidies, state programs and company PAP’s • 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
ABC will continue to foster and diffuse innovations that produce improved outcomes • ABC’s 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.
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
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