By Jeffrey Young - 01/03/07 12:00 AM EST
The sign-up period for prescription-drug coverage under Medicare Part D ended Sunday, and the Bush administration and observers of the program are eagerly waiting to see whether beneficiaries enrolled in plans best suited to their needs.
Encouraging elderly and disabled participants to reevaluate their 2006 plans, which changed in many cases, and compare them to other options on the market was the chief challenge during the second year of the program.
The Centers for Medicare and Medicaid Services (CMS), lawmakers, members of the health-insurance industry, and beneficiaries’ advocates widely predicted that most people enrolled in Part D would stick with the coverage they selected during the inaugural enrollment period, between November 2005 and May 2006.
Numerous opinion polls conducted in 2006 indicated that the majority of Part D beneficiaries were generally satisfied with their drug coverage, despite complaining that the program was too complicated.
But the private insurers that provide the drug coverage made numerous alterations to their plans for 2007, including changing premiums, deductibles, cost-sharing obligations and the drugs they cover.
Moreover, with the massive task of establishing a brand-new program completed, the administration scaled back its education and outreach programs for the 2007 enrollment period.
Nevertheless, the administration has expressed confidence that beneficiaries were smart shoppers during the six-week sign-up period.
In a conference call with reporters last week, acting CMS Deputy Administrator Herb Kuhn pointed to the high volume of calls to Medicare’s toll-free telephone hotline and of visits to Medicare’s website as signs that beneficiaries were not simply succumbing to inertia, even if most of them did not elect to change plans.
According to CMS, the “Plan Finder” website, which allows beneficiaries to compare Part D options, received 30 million page views between Oct. 15 and Dec. 27. Five million calls were made to the hotline.
At the close of 2005 and again when the sign-up period ended in May 2006, CMS experienced a spike in online and telephone inquiries and in enrollment. A CMS spokesman said yesterday that figures regarding how many beneficiaries looked for information or signed up for plans during the final days of this year’s enrollment period were not yet available.
An AARP lobbyist who is the group’s national coordinator for health issues, Kirsten Sloan, said, “I think you’ll find that most Medicare beneficiaries did shop around.”
AARP conducted its own multifaceted outreach program, which ranged from waging a national advertising campaign to hosting small educational events with beneficiaries. “There are a myriad of ways to get information,” Sloan, who praised CMS’s efforts, said.
The AARP famously endorsed the bill that created Part D, to the consternation of many Democratic lawmakers. AARP’s affiliated business operation co-sponsors a Part D plan with United Healthcare.
One critic of the program remains concerned that many beneficiaries did not realize that their benefits had changed, although he acknowledged that a final assessment is impossible until CMS releases its enrollment data.
“What portion of the Medicare population was aware of these changes? … We simply don’t know,” said Ron Pollack, president of the liberal healthcare advocacy group Families USA.
“Most people seemed unable to bear a whole new examination this year,” said Medicare Rights Center President Robert Hayes, who has been a fierce detractor of Part D. Hayes predicted that many beneficiaries will get unwelcome surprises as they learn about changes to their benefits later in the year, after it’s too late to change plans.
In addition to defending the quality of the benefits themselves, CMS and the health plans have had to answer for problems beneficiaries encountered when signing up for the program and accessing their benefits during the early months of Part D’s first year.
These problems generated intense criticism from congressional Democrats and some advocacy groups.
Hayes offered faint praise for CMS’s performance during the enrollment period of 2007. “Administratively, CMS is treading water competently,” he said. Hayes believes that the structure of Part D is too complex to administer and too difficult for beneficiaries to use.
Although the process appears to have gone substantially more smoothly for the 2007 coverage period, it has not been without problems.
CMS has acknowledged the some health plans, including United Healthcare, took too long to provide beneficiaries with information about alterations to their coverage. Approximately 250,000 people who did not receive an “annual notice of change” document by Oct. 31 will have until Feb. 15 to choose a plan, CMS said last week.
The availability of timely and accurate information on Part D plans, or the lack thereof, has been a recurrent theme in Democratic criticism of the program.
Incoming Senate Finance Committee Chairman Max Baucus (D-Mont.) was one of two Democrats who helped to write the bill that created Part D, but he frequently has expressed dissatisfaction with the administration’s and the health plans’ performance in disseminating information to beneficiaries.
The problems with the annual notices of change prompted strong words from Baucus. “It is unacceptable that a number of drug plans failed to uphold their fundamental responsibility to give this notice to Medicare beneficiaries,” he said in a written statement provided by his spokeswoman.
“We need to make sure that folks are getting all of the information that they need to make decisions during the open enrollment period,” Baucus said.
Baucus also reiterated his vow to pursue changes to Part D to make it “more consistent and simpler for seniors to use.”