Seniors don't use Medicare.Gov: how do eligible beneficiaries obtain information about Medicare Advantage Plans in the United States?

BACKGROUND: Managed care programs in the US are becoming a preferred alternative among low-income individuals in the US. Every year during open enrollment, seniors can enroll in Medicare Advantage (MA) or switch MA plans. However, there is very limited information about how seniors obtain information to help them make their choices. While the Centers for Medicaid and Medicare offer online resources that are designed to enable potential beneficiaries to make informed coverage decisions, there is no information as to whether seniors use these resources, and therefore whether these resources are effective compared to other information retrieval methods. METHODS: The purpose of the present study was to qualitatively explore how seniors obtain information about insurance plans in MA. We conducted semi-structured interviews with 26 MA beneficiaries from Rhode Island. RESULTS: We found that most seniors have strong preferences for obtaining information in-person regarding benefits, cost and other plan information. Some seniors relied heavily on insurance brokers or representatives, and considered the information provided to them without questioning the potential for bias. Others consulted with family and/or friends for guidance, or to compare costs and benefits. Only a few of these seniors used the available internet resources, and in fact most of them mentioned that they did not have a computer/smart device with internet capabilities. However, among those who used and appeared to be comfortable with navigating the internet, www.medicare.gov was not discussed as a useful resource for making decisions regarding health insurance. CONCLUSIONS: This study suggests that existing online medical resource usage and effects among senior citizens in the United States may need supplementing with in-person communication among influential agents.

Plan Switching and Stickiness in Medicare Advantage: A Qualitative Interview With Medicare Advantage Beneficiaries.

Approximately 34% of all Medicare beneficiaries were enrolled in a Medicare Advantage (MA) plan in 2019. Quantitative evidence suggests that MA beneficiaries have low rates of switching plans, but that beneficiaries who are hospitalized or use postacute nursing home care are disproportionately more likely to exit their plan. This research sought to explore how MA enrollees choose plans and the factors involved in their decision to keep their current plan or switch plans. We conducted 25 semistructured interviews focusing on expectations and experiences preenrollment and postenrollment among MA beneficiaries. Overall, the beneficiaries interviewed reported being highly satisfied with their plans. After selecting a plan, there was little incentive to revisit their choice since they viewed their plan as "good enough." Confusion, health status, cost and benefits also contributed to many seniors keeping or switching their plans. These seniors were reluctant to switch plans unless they experienced a major health event.

Evidence-Based Medicine and State Health Care Coverage: The Washington Health Technology Assessment Program.

OBJECTIVE: To evaluate the Washington State Health Technology Assessment Program (WHTAP). STUDY SETTING: Washington State Health Technology Assessment Program proceedings in Seattle, Washington. DATA COLLECTION AND STUDY DESIGN: We assessed the program through observation of its proceedings over a 5-year period, 2009-2014. We conducted detailed analyses of the documents it produced and reviewed relevant literature. PRINCIPAL FINDINGS: Washington State Health Technology Assessment Program is unique compared to other state and federal programs. It has successfully applied evidence-based medicine to health care decision making, limited by the strength of available data. It claims cost savings, but they are not substantiated. CONCLUSIONS: Washington State Health Technology Assessment Program is a useful model for other states considering implementation of technology assessment programs. We provide key lessons for improving WHTAP's process.

Marketing Residential Treatment Programs for Eating Disorders: A Call for Transparency.

Residential behavioral treatment is a growing sector of the health care industry and is used by a large proportion of adolescent and adult patients with eating disorders. These programs and the organizations that own them have developed extensive marketing strategies that target clinicians and include promotional gifts, meals, travel reimbursement, and continuing education credit. Legislation and policy changes have limited these types of activities when conducted by the pharmaceutical industry, and awareness of conflicts of interest associated with clinician-targeted advertising of drugs and devices has increased. However, similar practices by the behavioral health care industry have evolved without oversight. The authors urge clinicians to consider how marketing strategies by treatment facilities may influence their referral behaviors and call for improved transparency regarding gifts and payments from treatment facilities.