|
The National Center for Benefits Outreach and Enrollment is compiling a database of promising practices related to benefits outreach and enrollment. We invite you to review these promising practices and cost-effective strategies that can strengthen your local or state efforts to increase access to benefits for seniors and younger adults with disabilities.
AREA OF FOCUS: OUTREACH AND CONNECTION
Conducting Rural Outreach in Minnesota for Medicare
Savings Programs and State Pharmacy Assistance
Benefits outreach and enrollment in rural areas can face
a unique set of challenges. CMS funding enabled Minnesota
to identify useful outreach strategies, messaging and partnerships
for rural areas of the state. While findings may seem intuitive,
a quick review of their lessons learned can help you to
implement rural initiatives that 'hit the ground running'
and yield success.
Who was the target audience?
Seniors with limited incomes in rural areas of Minnesota.
What did they do?
In September 2000, CMS awarded a Medicare Savings Programs
Outreach grant to Minnesota. The grant was for the Department
of Human Services to work with the State Unit on Aging to
promote greater use of the Medicare Savings Programs (MSPs)
and pharmacy assistance program in rural areas of the state.
As of July 2000, a total of 42,000 people in Minnesota were
potentially eligible but not yet enrolled in an MSP, with
about half of those individuals living in rural areas of
the state. The project, begun in February 2001, targeted
six rural counties that were located across three Area Agency
on Aging regions: Southeast, Central, and Northwest Minnesota.
The counties were chosen based on their concentration of
senior citizens, rural locations, and established working
relationships between the regional county human services
offices and the local Area Agency on Aging.
This outreach was intended to target rural areas to: (1)
make individuals aware of the health care programs and their
benefits; (2) make the application process more accessible
and less intimidating; and (3) combat the negative connotations
about the health care programs. Through the project, the
Department of Human Services and State Unit on Aging hoped
to learn more about barriers to enrollment in these areas
and to identify the most effective means to tailor outreach
to the rural senior population.
The MSP rural outreach project was coupled with the State
Unit on Aging's promotional campaign for the Senior LinkAge®
Line. The state believed that combining the funding for
the projects would allow for a more in-depth and sustained
campaign. While the promotional efforts were to occur statewide,
additional resources would be concentrated in the selected
rural areas of the state. In developing their strategy to
reach out to seniors, especially those in rural areas, the
Department of Human Services and Minnesota Board on Aging
contracted with a social marketing consultant to plan outreach
activities that seemed especially suited to rural seniors.
Media Campaign
The state produced 30-second television commercials that
aired throughout the state during primetime viewing hours
for seniors, ran paid commercials on local radio stations
in rural pilot counties, and advertised in local newspapers
and shoppers. The campaign, which targeted seniors and their
caregivers, aimed to the raise awareness of the MSPs and
pharmacy assistance program and address negative connotations
with public benefits. Advertisements emphasized themes such
as financial benefit (for example, that the MSPs and pharmacy
assistance program would help alleviate worries about paying
for prescription drugs and Medicare costs and provide extra
pocket money each month) and entitlement to public benefits
(for example, by saying that people have earned the health
benefits by working hard during their lives, that the benefit
isn't “welfare,” and that applicants didn't have to visit
the welfare office to apply).
Informational Sessions and One-one-One Assistance
in the Community
To combat the welfare stigma that the state perceived and
to reach more isolated rural seniors, informational sessions
for seniors and caregivers were planned for non-governmental
sites, such as libraries, community rooms, senior centers,
and other gathering places. During the sessions, Area Agency
on Aging staff and SHIP volunteers were available to answer
questions regarding eligibility and to provide one-on-one
application assistance as needed. County workers in the
target areas also attended the sessions to provide information
and assistance. Attendees at the informational sessions
and callers to the Senior LinkAge® Line learned that SHIP
volunteers were available to conduct one-on-one, in-home
MSP application assistance.
Promotional materials
Partners distributed outreach materials (magnifying bookmarks,
brochures, flyers, posters, pamphlets, jar and door grippers,
and magnets) statewide at the information sessions and to
Meals on Wheels recipients to coordinate with the media
campaign. Tear-off prescription drug pads were delivered
to pharmacies, and posters and brochures were sent for display
to places of worship, senior centers, libraries, and other
local places visited by senior citizens in the rural counties
targeted by the grant, as well as throughout the state.
Pilot Application form
The Department of Human Services also used the outreach
campaign to pilot a new, seniors-only short form application
for health care programs in 14 rural counties, six of which
were participating in the rural outreach grant. Due to the
success of the form in the pilot regions, the state intends
to implement it statewide in 2002.
Piloting the senior application helped to cement existing
collaborative relationships between the county offices and
the local Area Agencies on Aging. County offices trained
Area Agency on Aging staff and SHIP volunteers on the use
of the pilot form. The trainings improved the capacity of
Agency on Aging staff and SHIP counselors to provide MSP
application assistance, thereby inspiring greater confidence
in their abilities by local public assistance staff. The
county human services staff began to routinely refer people
needing intensive assistance with applications to the Senior
LinkAge® Line to access one-on-one assistance from a SHIP
counselor.
What was the result?
Senior LinkAge® Line tracking software was used to identify
where people learned about the programs and which interventions
seemed to be most effective. Additionally, at the completion
of the project, the Department of Human Services held focus
groups with seniors in the target areas to determine the
effectiveness of the different outreach techniques.
Some observations from this campaign:
- The informational session sites drew large numbers of
attendees and did not appear to have the problem of a
"welfare stigma."
- Staff sensed that the sessions encouraged many people
to apply for the program, either by taking applications
with them, calling to obtain an application after the
presentation, or making an appointment with an SHIP counselor
for assistance.
- Churches and libraries were especially helpful in disseminating
information about the Medicare Savings Programs. Some
churches even announced the basic eligibility factors
during services.
- The value of intensive coordination and communication
between the regional Area Agency on Aging and county eligibility
workers, became readily apparent. The Department of Human
Services planned to foster this kind of collaboration
statewide after the completion of the grant.
- Parties interviewed felt that messages about assistance
with prescription drugs and ways to stretch monthly income
seemed to have the most resonance with beneficiaries and
their families.
- The biggest remaining barrier to persons enrolling in
the programs seemed to be estate recovery (which will
not longer be permissable for MSP as of January 1, 2010.)
- Finally, the response to the television commercials
seemed lower than expected, but the State Unit on Aging
anticipated that the response rate would grow with repetition
of the information in the coming radio and print campaign
and the continued exposure to outreach initiatives in
the community. Some people may not actually apply for
an MSP until they hear the message over and over again—as
many as three to seven times through a variety of sources.
Ultimately, the state concluded that television was not
a cost-effective medium for outreach. It is very expensive
to produce an appealing and effective television spot
and to have it repeatedly shown during peak viewing hours.
For more information:
K. Glaun, “Medicaid Programs to Assist Low Income Medicare
Beneficiaries: Working Paper on Medicare Savings Programs
in Minnesota.” Kaiser Commission on Medicaid and the Uninsured
(2002). To see the full report, click here.
|
