Department of Health and Human Services 

OFFICE OF 

INSPECTOR GENERAL 

BENEFICIARY AWARENESS OF HCFA


PUBLICATIONS


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JUNE GIBBS BROWN 

Inspector General 

JUNE 1995 

OEI-04-93-00141 
OFFICE OF INSPECTOR GENERAL 

The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, as 

amended, is to protect the integrity of the Department of Health and Human Services’ (HHS) 

programs as well as the health and welfare of beneficiaries served by those programs. This 

statutory mission is carried out through a nationwide network of audits, investigations, and 

inspections conducted by three OIG operating components: the Office of Audit Services, the 

Office of Investigations, and the Office of Evaluation and Inspections. The OIG also informs 

the Secretary of HHS of program and management problems and recommends courses to 

correct them. 

OFFICE OF AUDIT SERVICES 

The OIG’S Office of Audit Services (OAS) provides all auditing setices for HHS, either by 

conducting audits with its own audit resources or by overseeing audit work done by others. 

Audits examine the performance of HHS programs and/or its grantees and contractors in 

carrying out their respective responsibilities and are intended to provide independent 

assessments of HHS programs and operations in order to reduce waste, abuse, and 

mismanagement and to promote economy and efficiency throughout the Department. 

OFFICE OF INVESTIGATIONS 

The OIGS Office of Investigations (01) conducts criminal, civil, and administrative 

investigations of allegations of wrongdoing in HHS programs or to HHS beneficiaries and of 

unjust enrichment by providers. The investigative efforts of 01 lead to criminal convictions, 

administrative sanctions, or civil money penalties. The 01 also oversees State Medicaid fraud 

control units which investigate and prosecute fraud and patient abuse in the Medicaid program. 

OFFICE OF EVALUATION AND INSPECTIONS 

The OIG’S Office of Evaluation and Inspections (OEI) conducts short-term management and 

program evaluations (called inspections) that focus on issues of concern to the Department, 

the Congress, and the public. The findings and recommendations contained in these inspection 

reports generate rapid, accurate, and up-to-date information on the efficiency, vulnerability, 

and effectiveness of departmental programs. 

OEI’S Atlanta Regional Office prepared this report under the direction of Jesse J. Flowers, 

Regional Inspector General, and Christopher Koehler, Deputy Regional Inspector General. 

Principal OEI staff included: 

Atlanta Region Headquarter


Betty Apt, Team Leader Tom Noplock, ProgramSpecialist


James Green, Contractor Brian Ritchie, Technical Support


Peggy Daniel, ProgramAnalyst Jennifer Antico, ProgramSpecialist


Jackie Andrews, ProgramAnalyst Barbara Tedesco, Statistician


Joe Townsel, ProgramAnalyst


Tammy Bonney, ProgramAna@st


To obtain a copy of this report, call the Atlanta Regional Office at (404) 331-5022. 
Department of Health and Human Services 

OFFICE OF


INSPECTOR GENERAL 

BENEFICIARY AWARENESS OF HCFA


PUBLICATIONS


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> OEI-04-93-O0141 
EXECUTIVE SUMMARY


PURPOSE 

To determine Medicare beneficiary awareness of booklets the Health Care Financing 

Administration publishes to assist beneficiaries with health care decisions. 

BACKGROUND 

The Health Care Financing Administration (HCFA) publishes various booklets 

designed to help Medicare beneficiaries make informed health care decisions. The 

booklets are available from several sources, such as Social Security offices and senior 

citizen organizations. However, the department has little information on the extent 

that beneficiaries know the booklets are available. 

As part of our 1994 survey to determine beneficiary satisfaction with Medicare, we 

asked beneficiaries about their awareness of the Medicare Handbook and seven other 

HCFA publications. These eight publications included the handbook and two booklets 

on selecting Medigap insurance and nursing homes we reported on in 1993. 

FINDINGS 

Most beneficiaries were aware of the Medicare Handbook 

Three-fourths of the beneficiaries surveyed in 1993 and 1994 said they knew about the 

Medicare Handbook. Most of them thought it was helpful, easy to read and 

understand, and contained adequate information. 

Awareness of the Medigap guide increased since 1993 

The percent of beneficiaries who were aware of HCFA’S Guide to Health Insurance for 

People with Medicare increased from 13 percent in 1993 to 24 percent in 1994. 

Awareness of the nunsing home guide was about the same in 1993 and 1994 

The percent of beneficiaries who were aware of HCFA’S Guide to Choosing a Numing 

Home decreased slightly from nine percent in 1993 to eight percent in 1994. 

Few beneficiaries were aware of other HCFA publications 

The percent of beneficiaries aware of five other HCFA publications ranged from 4 to 

14 percent. 

�	 Fourteen percent of the Medicare beneficiaries who responded to our survey 

were aware of HCFA’S Medicare and Other Health Benefits. 

i 
� 

� 

� 

� 

Nine percent of the Medicare beneficiaries who responded to our survey were 

aware of HCJ?A’S Medicare Coverage for Second Su~ical Opinions. 

Nine percent of the Medicare beneficiaries who responded to our survey were 

aware of HCFA’S Medicare Hospice Benefits. 

Six percent of the Medicare beneficiaries who responded to our survey were 

aware of HCFA’S Medicare and Coordinated Care Plans. 

Four percent of the Medicare beneficiaries who responded to our survey were 

aware- of HCFA’S Medicare Savings for Qualified Benej7ciaries. 

We realize that awareness of these publications may depend on a beneficiary’s needs. 

Further, these publications are referenced in HCFA’S Medicare Handbook which most 

beneficiaries are aware of. 

RECOMMENDATION 

We recommend that HCFA continue their current efforts, as well as experiment with 

new methods, to develop a more effective strate~ to increase beneficiary awareness of 

their publications. 

AGENCY COMMENTS 

The HCFA Administrator commented on our draft report, and concurred with our 

findings. He reported that HCFA has several initiatives underway designed to educate 

Medicare beneficiaries and providers about Medicare’s home health coverage. For 

example, HCFA is developing a new pamphlet to be distributed to organizations and 

health care providers who serve beneficiaries. The Administrator reported HCFA is 

also working to improve the readability and distribution of existing publications. 

.. 

11 
TABLE OF CONTENTS


PAGE 

EXECUTIVE SUMMARY 

INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


FINDINGS 

� Most Beneficiaries Were Awareof the A4edicareHandbook . . . . . . . . . . . . . . . 5


� Awareness of HCFA’S Medigap Guide Increased Since 1993 . . . . . . . . . . . . . . . 5


�	 Awareness of HCFA’S Nursing Home Guide Was About the Same


in 1993 and 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...6


� Few Beneficiaries Were Aware of Other HCFAPublications . . . . . . . . . . . . . . 6


RECOMMENDATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7


AGENCY COMMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8


APPENDICES


Responsesto 1993 Survey of Medicare Beneficiaries . . . . . . . . . . . . . . . . . . . A-1


Responsesto 1994 Sumeyof Medicare Beneficiaries . . . . . . . . . . . . . . . . . . . B-1


HCFA Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..C-l

INTRODUCTION


PURPOSE 

To determine Medicare beneficiary awareness of booklets the Health Care Financing 

Administration publishes to assist beneficiaries with health care decisions. 

BACKGROUND 

Medicare Program 

Medicare is a Federal health insurance program for individuals age 65and older and 

forcertain categories ofdisabled people. Authorizedin 1965 bytitle XVIII of the 

Social Security Act, Medicare paid benefitsin 1993 totalling $143 billionth 

approximately 36 million beneficiaries .1 The Health Care Financing Administration 

(HCFA) within the Department of Health and Human Services has responsibility for 

the Medicare program. 

HCFA I%blications 

HCFA publishes a handbook for beneficiaries that explains how the Medicare 

program works and what the benefits are. HCFA also publishes various booklets 

designed to help beneficiaries make informed health care decisions. The booklets 

provide (1) guidance on Medicare coverage for specific services, such as hospice and 

second surgical opinions, and (2) advice on criteria beneficiaries should consider in 

selecting services, such as nursing home care and supplemental health insurance. 

The handbook is mailed to new beneficiaries when they enroll, and to all beneficiaries 

when major changes are made to the Medicare program. The booklets are available 

upon request from several sources, such as Social Security offices, insurance offices 

that process Medicare claims (called carriers), and senior citizen organizations. 

However, the department has little information on the extent that beneficiaries know 

the booklets are available. 

Prevwus survey 

In 1993, the Office of Inspector General conducted a survey of Medicare beneficiaries 

to determine their awareness of the handbook and two booklets published by HCFA. 

The two booklets provided guidance to beneficiaries and their families to help them 

select nursing homes and health insurance to supplement Medicare coverage 

(Medigap insurance). 

lHealth Care Financing Administration, United States Department of Health and Human Services. 

HCFA Statistics, July 1994 

1 
We found that three-fourths of the beneficiaries were aware of the handbookz, but 

few beneficiaries (less than 15 percent) knew about the two booklets3. However, 

most beneficiaries who had used the handbook and booklets found them useful. 

METHODS 

1994 Swvqv 

In July 1994, we mailed a questionnaire to 1279 randomly selected Medicare 

beneficiaries for whom Part B claims had been filed in Calendar Year 1993. Based on 

previous experience with similar beneficiary sumeys, the sample size was calculated to 

produce an estimate within 3.5 percent of the true value at the 95 percent confidence 

level. We used standard equations for estimating sample size with a binary response 

variable. 

k part of our 1994 survey to determine beneficiary satisfaction with Medicare,4 we 

asked beneficiaries about their awareness of eight HCFA publications. The eight 

publications included the Medicare Handbook, which all beneficiaries receive, and 

seven other publications that HCFA requested we include. The eight booklets are 

described below. 

� HCFA’S Medicare Handbook explains the Medicare program and benefits. 

�	 HCFA’S Guide [o Health Insurance for People with Medicare Coverage provides 

information on (1) Medicare coverage, (2) types of Medigap policies, and (3) 

tips for purchasing Medigap insurance. 

�	 HCFA’S Guide to Choosing a Nursing Home contains information on (1) factors 

to consider in selecting a nursing home, and (2) Medicare and Medicaid 

coverage of nursing home care. 

�	 HCFA’S Medicare and Other Health Benej7ts explains how Medicare coordinates 

with other insurance that beneficiaries may have, such as Medigap, employer 

health plans, and Workman’s Compensation. 

�	 HCFA’S Medicare Coverage for Second Wgical Opinions provides information 

on (1) when beneficiaries should get second surgical opinions, (2) how to find 

20 ffice of Inspector General, United States Department of Health and Human Services. Medicare 

Beneficial Satisfaction: 1993. 0EI-04-92-O0480, August 1993 

30 ffice of Inspector General, United States Department of Health and Human Services. Use 

of Nursing Home and Medigap Guides. OEI-04-92-00481, May 1994 

40 ffice of Inspector General, United States Department of Health and Human Serviees. Medicare 

BenejkiaU Satisfaction: 1994. 0EI-04-92-O0480, December 1994 

2 
physicians togivesecond surgical opinions, (3)and Medicare payments for 

second surgical opinions. 

�	 HCFA’S Medicare Hospice Benefits explains (1) hospice services, (2) eligibility 

requirements, and (3) Medicare payments for hospice services. 

�	 HCFA’S Medicare and Coordinated Care Plans contains information on 

managed health care plans (health maintenance organizations and competitive 

medical plans) that contract with HCFA to provide health care for Medicare 

beneficiaries, 

�	 HCFA’S Medicare Savings for Qual~ied Beneficiaries explains how Medicare can 

pay additional medical costs for certain low-income Medicare beneficiaries. 

Beneficiary participation in the survey was voluntary. A total of 1002 beneficiaries 

returned completed questionnaires, for a response rate of 78 percent. Given the size 

of our sample and response rate, results of our survey are protectable to the universe 

of 36 million beneficiaries. Appendix A shows beneficiary responses. 

Comparison to Previous Surveys 

We compared beneficiary responses to the 1993 survey to beneficiary responses to the 

1994 survey on questions about the Medicare Handbook. We also compared 

beneficiary responses on two other publications--the nursing home and Medigap 

booklets. 

The two booklets on selecting nursing homes and Medigap insurance we previously 

reported on in 1993. We could not determine if the difference in responses in 1993 

and 1994 were statistically significant because we worded the question about 

beneficiary awareness differently those two years. 

In 1994, we asked beneficiaries about their awareness of the health insurance and 

nursing home guides in a list of seven publications. Only those beneficiaries who were 

aware of one or more of the seven publications should have answered the question. 

Therefore, we calculated our percentages of beneficiary awareness and unawareness of 

the guides using the number of beneficiaries who responded to the survey (1002). We 

interpreted each non-response to the question as meaning that the beneficiary was not 

aware of any of the seven publications listed in the question. That interpretation is 

consistent with the instructions we gave in the questionnaire. 

In 1993, we asked about awareness of the health insurance and nursing home guides 

in two separate questions. All beneficiaries responding to the survey should have 

answered the questions to say they either were aware of the booklets or they were not 

aware. However, some beneficiaries skipped the questions. Since we did not know 

whether or not they were aware of the booklets if they skipped the question, we 

calculated the percentages aware and unaware in our report Use of Nursing Home and 

3 
Medigap Guides (OEI-04-00481) using the number of people who answered the 

question. In order to compare 1993 responses to 1994 responses, we recalculated 

percentages for 1993 using the number of beneficiaries responding to the survey 

(1053). 

See appendix A for beneficiary responses to the 1993 survey, and appendix B for 

beneficial responses to the 1994 survey. 

We conducted this inspection in accordance with the Quality Standards for Inspechons 

issued by the President’s Council on Integrity and Efficiency. 

4

FINDINGS


MOST BENEFICIARIES WERE AWARE OF MEDICARE lL4.NDBOOK 

Three-fourths of the beneficiaries surveyed said they knew about the Medicare 

Handbook, Beneficiaries responded virtually the same in both the 1993 and 1994 

surveys. 

A little over 40 percent of the beneficiaries surveyed had used the handbook in the 

previous year. Ofthebeneficiaries whohadused the handbook: 

� over 90 percent thought the handbook was helpful, 

� over 90 percent thought the print was large enough to read, 

� over 85 percent thought the handbook contained adequate information, and 

� over 80 percent thought the wording was easy to understand. 

In both the 1993 and 1994 surveys, half of the beneficiaries surveyed said they would 

refer to their Medicare Handbook to get information about their Medicare benefits. 

AWARENESS OF THE MEDIGAP GUIDE INCREASED SINCE 1993 

Table 1 shows that beneficiary awareness of the Guide to Health Insurance for People 

wi~hMedicare increased 11 percent between 1993 and 1994. 

TABLE 1 

AWARENESS OF MEDIGAP GUIDE 

PUBLICATION 1993 1994 

Guide to Health Insurance for People


with Medicare 13705 24%


Although we could not determine what caused the increased awareness of the


Medigap guide, we recognize that HCFA is developing strategies to make beneficiaries


more cognizant of the publication. For example, staff from HCFA and the Social


50ur report Use of Nursing Home and Medigap Guides (OEI-04-92-00481) shows 14 percent because 

we calculated the percentage differently, as explained in the Methodology section of this report. 

5 
Security Administration have been meeting quarterly to improve coordination and the 

dissemination of information to beneficiaries. 

AWARENESS OF THE NURSING HOME GUIDE WAS ABOUT THE SAME IN 

1993 AND 1994 

Table 2 shows that less than 10 percent of beneficiaries surveyed knew about the 

Guide to Choosing a Nursing Home in both 1993 and 1994. 

TABLE 2 

AWARENESS OF NURSING HOME GUIDE 

PUBLICATION 1993 1994 

f 1 

Guide to Choosing a Nursing Home 99Z0 8% 

FEW BENEFICIARIES WERE AWARE OF OTHER HCFA PUBLICATIONS 

Table 3 illustrates that the percent of beneficiaries aware of five HCFA publications 

other than the Medigap and nursing home guides ranged from 4 to 14 percent of the 

1002 beneficiaries responding to our survey. 

TABLE 3 

AWARENESS OF HCFA PUBLICATIONS 

PUBLICATION BENEFICIARIES 

AWARE 

Medicare and Other Health Benefits 1470 

Medicare Coverage for Second Surgical Opinions 9% 

Medicare Hospice Benefits 9V0 

IIMedicare and Coordinated Care Plans I 6% II 

Medicare Savings for Qualified Beneficiaries 4% 

We realize that awareness of these publications may depend on a beneficiary’s needs. 

For example, it is understandable that a beneficial who has not needed surge~ may 

not be aware of the publication on second surgical opinions. 

6

RECOMMENDATIONS


HCFA publications provide information that Medicare beneficiaries and their families 

may use to make informed health care decisions. However, they cannot benefit from 

the guidance if they do not know the information is available. 

Publications such as the Medicare Handbook and the Guide to Health Insurance for 

People with Medicare have broader applicability to beneficiaries. We noted that the 

rate of awareness for these publications is higher than for other publications. We also 

realize that awareness of some of the other publications, such as the pamphlet on 

hospice benefits, may depend on a beneficiary’s needs. Further, those publications 

that beneficiaries are less aware of are referenced in HCFA’S Medicare Handbook 

which most beneficiaries do know about. 

As our 1993 report on the nursing home and Medigap guides acknowledged, HCFA is 

working with the Social Security Administration and the Assistant Secretary for Public 

Affairs to make HCFA information more accessible to beneficiaries. That effort 

seems to be working for the Medigap booklet we studied in 1993. HCFA’S current 

work with the National Association of Insurance Commissioners (NAIC) should also 

increase awareness of the Medigap guide. HCFA and NAIC are developing disclosure 

statements which are provided to beneficiaries who purchase Medigap insurance. The 

statements refer potential Medigap buyers to the Guide to Health Insurance for People 

with Medicare. 

We recommend that HCFA continue their current efforts, as well as experiment with 

new methods, to develop a more effective strategy to increase beneficiary awareness of 

their publications. 

Some new methods that HCFA might consider for experimentation are listed below. 

�	 HCFA could distribute publications, or a listing of publications through offices 

of physicians and other health care providers. 

�	 HCFA carriers could include a listing of HCFA publications with the 

Explanation of Medicare Benefits sent to beneficiaries after claims for Part B 

services have been processed. 

� Post Offices could display a listing of HCFA publications. 

7

AGENCY COMMENTS


The HCFA Administrator commented on our draft report, and concurred with our 

findings. He reported that HCFA has several initiatives underway designed to educate 

Medicare beneficiaries andproviders about Medicare's home health coverage. For 

example, HCFA is developing a new pamphlet to be distributed to organizations and 

health care providers who serve beneficiaries. The Administrator reported HCFA is 

also working to improve the readability and distribution of existing publications. 

Appendix C shows the full text of comments provided by HCFA. 

8

APPENDIX A 

RESPONSES TO THE 1993 SURVEY 

OF MEDICARE BENEFICIARIES 

A-1 
RESPONSES TO 1993 SURVEY OF MEDICARE BENEFICIAR~ 

(1053 Respondents) 

Question Responses Percentage 

1.	 The following are some places people might go to get answers if they have 

questions about what Medicare pays for. Wherewouldyougo to get 

information about what Medicare 

(Check all that apply) 

(N = 1025- Number Responding 

Your doctor’s office 

Friend or relative 

AARP or other 

membership organization 

Insurance company that 

process your Medicare claims 

Social Security office 

Local senior citizen’s group 

Insurance salesperson 

Medicare Handbook 

Other 

Not Answering: 28 

pays for? 

to Question) 

495 48 

103 10 

200 20 

324 32 

465 45 

83 8 

17 2 

552 54 

40 4 

2. How many times in the past year have you used your Medicare Handbook? 

(Check ~ answer.) 

1 to3 times 

More than 3 times 

I have never used the 

Medicare Handbook 

I do not know what the 

Medicare Handbook is 

I do not recall receiving 

Medicare Handbook 

Not Answering: 79 

368 36 

57 6 

345 34 

27 3 

a 

213 21 

A-2

Question Responses Percentage 

3.	 Do you think the Medicare Handbook is: 

(Check ~ answer.) 

(N = 425- Number Who Had Used Handbook) 

Very Helpful 113 27 

Generally Helpful 272 66 

Generally Not Helpful 19 5 

Not Helpful 7 2 

Not Answering: 14 

4.	 Thinking about the Medieare Handbook you have reeeived, would you say 

that... 

(N = 425- Number Who Had Used Handbook) 

a. The wording is easy to understand? 

Yes 314 80 

No 78 20 

Not Answering: 33 

b. The lettering is large enough to read? 

Yes 345 94 

No 23 6 

Not Answering: 57 

c. It covers enough information? 

Yes 284 85 

No 51 15 

Not Answering: 90 

A-3

Question Responses Percentage 

5.	 Medicare publishes a booklet entitled “Guide to Health Lwurance for People 

with Medicare.” It discusses things you should look for in choosing Medigap 

insurance to supplement your Medieare coverage. It is available at yOUIStia.1 

Security office. 

Before today, were you aware Medieare had a booklet to help you 

choose other health insurance? 

Yes 139 14 

No 875 86 

Not Answering: 39 

6.	 Medicare also has a booklet entitled “Guide to Choosing a Niming 

Home.” It discusses things to look for in selecting a nursing home, and is 

available from several offices, including your Social Security office. 

Before today, were you aware Medicare had information on choosing a 

nursing home? 

Yes 93 9 

No 917 91 

Not Answering: 43 

A-4

APPENDIX B 

RESPONSES TO THE 1994 SURVEY 

OF MEDICARE BENEFICIARIES 

B-1 
RESPONSES TO 1994 SURVEY OF MEDICARE BENEFIC~ 

(1002 Respondents) 

Question Responses Percentage 

1.	 The following are some places people might go to get answers if they have 

questions about what Medicare pays for. Where would you go to get 

information about what Medicare 

(Check all that apply.) 

(N = 973- Number Responding 

Your doctor’s office 

Friend or relative 

AARP or other 

membership organization 

Insurance company that 

processes your Medicare claims 

Social Security office 

Local senior citizens’ group 

Insurance salesperson 

Medicare Handbook 

Medicare Peer Review 

Organization (PRO) 

Other 

Not Answering: 29 

pays for? 

to Question) 

486 

67 

135 

411 

337 

58 

24 

518 

107 

26 

50 

7 

14 

42 

35 

6 

2 

53 

11 

3 

2. How many times in the past year have you used your Medicare Handbook? 

(Check ~ answer.) 

1 to 3 times 

More than 3 times 

I have never used the 

Medicare Handbook 

I do not know what the 

Medicare Handbook is 

I do not recall receiving 

Medicare Handbook 

Not Answering: 79 

331 36 

77 8 

297 32 

27 3 

a 

191 21 

B-2

Question Responses Percentage 

3.	 Do you think the Medicare Handbook is: 

(Check ~ answer.) 

(N= 408- Number Who Had Used Handbook) 

Very Helpful


Generally Helpful


Generally Not Helpful


Not Helpful


Not Answering: 17


123 31 

249 64 

14 4 

5 1 

4.	 Thinking about the Medicare Handbook you have received, would you say that... 

(N = 408- Number Who Had Used Handbook) 

a. The wording is easy to understand? 

Yes 312 

No 58 

Not Answering: 38 

b. The lettering is large enough to read? 

Yes 326 

No 25 

Not Answering: 57 

c. It covers enough information? 

Yes 290 

No 42 

Not Answering: 76 

84 

16 

93 

7 

87 

13 

B-3

Question Responses Percentage 

5. Listed below are Medicare booldets that you can obtain free. Before 

@&, were you aware that you could obtain the following free 

publications from Medicare? 

(Please check the booklets you were aware of before todav.) 

Guide to Health Insurance 

for People with Medicare 

Guide 10 Choosing a 

Nursing Home 

Medicare: Coverage for 

Second Surgical Opinion 

Medicare: Hospice Benefits 

Medicare and Coordinated 

Care Plans 

Medicare and Other 

Health Benefits 

Medicare: Savings for Qualified 

Beneficiaries 

237 24 

78 8 

94 9 

90 9 

59 6 

141 14 

42 4 

Number Who Checked One or More Publications: 405 

Number Who Did Not Check Any Publications: 597 

B-4

APPENDIX C 

HCFA COMMENTS 

c-1 
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A

.1,,,$ < Health Care +’ 

. DEPARTMENT 01- HEALTH & HUMAN SERVICES Financing Administration *’ 

:

< 

“. Memorandum 

DATE APR28 K195 

FROM	 Bruce C. Wade 

Administrator %-

SUBJECT	 Office of Inspector General Draft Report: “Beneficiary Awareness of 

HCFA Publications,” (OEI-04-93-O0141) 

TO	 June Gibbs Brown 

Inspector General 

We reviewed the subject draft report which examined beneficia~ awareness of booklets 

the Health Care Financing Administration publishes to assist beneficiaries with health 

care decisions. Our comments are attached for your consideration. 

Thank you for the opportunity to review and comment on this report. Please advise us if 

you would like to discuss 

Attachment 

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our position on the report’s recommendation. 

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Comments of the Health Care Financing Administration (HCFA]


on Office of Inspector General [OIG) Draft Report:


“Beneficiary Awareness of HCFA Publications,”


(OEI-04-93-00141)


OIG Recommendation


HCFA should continue their current efforts, as well as experiment with new methods, to


develop a more effective strategy to increase beneficiary awareness of their publications.


Some new methods that HCFA might consider for experimentation are listed below.


o	 HCFA could distribute publications, or a listing of publications, through 

offices of physicians and other health care providers. 

o	 HCFA carriers could include a listing of HCFA publications with the 

Explanation of Medicare Benefits sent to beneficiaries after claims for 

Part B services have been processed. 

o Post offices could display a listing of HCFA publications. 

HCFA Response


We concur. As mentioned in the report, HCFA is engaged with internal and external


partners to increase the awareness and distribution of its publications. We have several


initiatives under way for fiscal year 1995 designed to educate Medicare beneficiaries and


providers about what Medicare’s home health benefit covers and pays for. These


initiatives employ multimedia and multiuser approaches to guarantee maximum use and


benefit.


First, a pamphlet has been developed which explains Medicare home health coverage,


eligibility, fraud, and quality concerns. It is currently being reviewed by HCFA


component staff, several beneficiary and home health organizations, and Medicare


beneficiaries. We anticipate having a final revised version of the pamphlet complete by


July/August 1995. The pamphlet will be distributed to groups and organizations that


provide counseling and assistance services to beneficiaries such as the Information


Counseling and Assistance (ICA) Program State grantees, the Retired Seniors Volunteer


Program, and others. It will also be distributed to hospitals to be shared with the staff


(hospital discharge planners and social workers) who assist beneficiaries with their


posthospital health care needs. We also intend to distribute copies of the pamphlet to


professional provider organizations such as the American Medical Association and


American Nurses Association. We recognize that doctors need to understand this benefit


because many beneficiaries consult with their doctors about Medicare coverage. Hence,


we will encourage these organizations to put the pamphlet in their newsletters-and other


correspondence that goes to their members.