Medicare Part D: CMS Has Implemented Processes to Oversee Plan Finder Pricing Accuracy and Improve Website Usability
Published: 2014-01-10T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: The Medicare prescription drug program, known as Medicare Part D, provides a voluntary outpatient prescription drug benefit for Medicare beneficiaries. Beneficiaries may choose Part D plans from among multiple plans offered by private companies--plan sponsors--that contract with CMS. Plans may differ in their premiums and cost-sharing arrangements, the drugs they cover, and the pharmacies they contract with to fill prescriptions. CMS developed the Medicare Plan Finder interactive website in 2005 as a tool to help beneficiaries compare Part D plans and identify plans that meet their needs. For Plan Finder to serve its intended purpose, beneficiaries and their advisers need to be able to obtain accurate drug cost information, understand plan options, and navigate the website effectively.
GAO was asked to review CMS's efforts to ensure that beneficiaries can use Plan Finder effectively. This report examines (1) how CMS oversees the accuracy of drug pricing information in Plan Finder; and (2) how CMS assesses the usability of Plan Finder and any steps CMS has taken to improve it. To conduct this work, GAO reviewed documentation detailing CMS's processes for overseeing Plan Finder pricing accuracy and obtained data on agency compliance actions. GAO also interviewed CMS officials and organizations that help Medicare beneficiaries navigate Plan Finder to learn about CMS's processes for obtaining feedback on Plan Finder's usability and steps the agency has taken to improve the website.
section_title: What GAO Found
paragraphs: The Centers for Medicare & Medicaid Services (CMS), the agency within the Department of Health and Human Services (HHS) that administers Medicare, uses data checks and quality measures to oversee the accuracy of Part D plan pricing information on the Plan Finder interactive website. Part D sponsors may have multiple contracts with CMS to provide drug coverage, with each contract covering one or more distinct Part D plans, and CMS is responsible for overseeing plan sponsors' compliance with their Part D contracts. CMS requires Part D plan sponsors to submit drug pricing information for their plans, which Plan Finder uses to estimate beneficiaries' cost-sharing amounts and expected annual drug costs. To ensure the accuracy of this information,
CMS performs computerized data checks on the pricing information for each plan to identify incomplete and potentially inaccurate data before information is displayed on Plan Finder. If CMS's data checks identify potentially inaccurate plan pricing information, CMS gives the plan's sponsor an opportunity to attest to the accuracy of the data, or correct it. If the plan's sponsor does not verify or correct potential inaccuracies identified by these checks, CMS will "suppress" the plan from Plan Finder, which means that the plan's pricing information is removed and that beneficiaries cannot enroll in the plan through the website. In the first seven months of 2013, 25 percent of Part D contracts had one or more plans suppressed from Plan Finder at least once. CMS has taken compliance actions against plan sponsors for repeated suppressions--between January 1, 2009, and July 31, 2013, CMS issued 89 notices of noncompliance and 67 warning letters.
CMS uses quality measures to evaluate the accuracy of pricing information on Plan Finder. As part of its Part D Star Ratings, which provide beneficiaries with information on plan quality, CMS collects performance data on Part D plans covered under each individual contract. CMS assigns scores to each contract based on the extent to which beneficiaries' point-of-sale costs were higher than prices posted on Plan Finder. For the 2013 Star Ratings, 6 percent of contracts had point-of-sale prices that were greater than Plan Finder prices by an average of 4 percent or more.
CMS has assessed the usability of Plan Finder by obtaining feedback from a variety of sources, including beneficiary assistance organizations, user testing, a website survey, and website user data. CMS has used feedback on Plan Finder to update the website and improve usability. For example, CMS developed and added a "frequently asked questions" webpage to the website. Officials from the beneficiary organizations GAO spoke with generally said that Plan Finder helps beneficiaries compare Part D plans and that its usability has improved over time.

section_title: Letter
paragraphs: The Medicare prescription drug program, known as Medicare Part D,  provides a voluntary outpatient prescription drug benefit for Medicare  beneficiaries. As of January 2013, nearly 34 million beneficiaries were  enrolled in Part D. Beneficiaries may choose Part D plans from among  multiple plans offered by private companies—Part D plan sponsors—that  contract with the Centers for Medicare & Medicaid Services (CMS), the  agency within the Department of Health and Human Services (HHS) that  administers Medicare. Part D plan sponsors may have multiple contracts  with CMS to provide drug coverage, with each contract covering one or  more distinct Part D plans. Plans may charge different monthly  premiums and have different beneficiary cost-sharing arrangements— such as deductibles and copayments or coinsurance for covered drugs.  In addition, plans may differ in the drugs they cover and the pharmacies  they contract with to fill prescriptions.
Beneficiaries’ annual drug costs—the total amount beneficiaries pay in  premiums, cost-sharing, and costs for non-covered drugs each year— vary depending on which Part D plans they choose. Drug costs vary  based on plans’ benefit structures and drug coverage, the costs and  amount of drugs needed, and the pharmacies the beneficiaries use. In  addition, beneficiaries’ drug costs can change from one year to the next  as their drug needs change, and as plans modify their premiums, cost- sharing arrangements, and drugs they cover each year.
Given the variation amongst plans and the numerous factors affecting  beneficiaries’ drug costs, beneficiaries may face challenges comparing  plans and may not enroll in plans that best meet their needs. Several  studies have found that most beneficiaries could have saved money had  they enrolled in lower-cost plans available to them based on their   Other studies have also found that even though  prescription drug needs. beneficiaries are eligible to switch plans each year as their needs change,  relatively few beneficiaries reevaluate their plan options or switch plans.
To help beneficiaries compare Part D plans and identify plans that meet  their needs, CMS developed the Medicare Plan Finder interactive  website.  Plan Finder uses coverage and prescription drug pricing information that Part D plan sponsors are required to submit, along with  information entered by beneficiaries on the prescription drugs they take  and the pharmacies they use, to estimate beneficiaries’ cost-sharing  amounts and expected annual drug costs. Plan Finder also provides  beneficiaries with information on CMS’s ratings of the quality of each  plan, based on their performance across a range of quality measures. For  Plan Finder to serve its intended purpose effectively, beneficiaries and  their advisers need to be able to obtain accurate drug coverage and cost  information, understand available plan options, and navigate the website.
You asked us to review CMS’s efforts to ensure that beneficiaries can use  Plan Finder effectively. We examined (1) how CMS oversees the  accuracy of drug pricing information in Plan Finder and (2) how CMS  assesses the usability of Plan Finder and any steps that CMS has taken  to improve it.
To examine how CMS oversees the accuracy of drug pricing information  in Plan Finder, we interviewed officials from CMS on their processes for  ensuring Plan Finder pricing accuracy and for taking compliance actions  against Part D plan sponsors that do not provide accurate Plan Finder  pricing information. We reviewed documentation describing the data  checks performed by CMS to identify outlying and inaccurate pricing  information submitted by Part D plan sponsors. We also obtained  documentation related to CMS compliance activities, including  documentation associated with an instance of noncompliance that was  referred by CMS to the Department of Justice. We analyzed data on  actions taken by CMS when plan sponsors did not submit accurate drug  pricing information, including data from CMS’s Compliance Activity  Module—CMS’s data repository for compliance actions taken against   Part D plan sponsors— from January 1, 2009, through July 31, 2013.CMS tracks compliance activities by the individual contract. We also  reviewed CMS’s Star Ratings performance data, which assigns scores to  individual Part D contracts based on the performance of plans covered  under the contracts across a range of quality measures, from 2011  through 2013.reviewed them for reasonableness and consistency; we determined that  the data were sufficiently reliable for our purposes.
We discussed these data with agency officials and  To examine how CMS assesses the usability of Plan Finder and any  steps that CMS has taken to improve it, we interviewed CMS officials  regarding their processes for obtaining feedback on the usability of Plan  Finder and addressing any identified issues. We obtained documentation  describing changes made to the website from January 1, 2011, through  July 31, 2013, along with documentation associated with beneficiary user  testing and website surveys conducted by CMS. We also obtained  agency data on the total number of beneficiary enrollments in Part D  plans, and the number of beneficiary enrollments through the website  from January 1, 2009, through July 31, 2013.with agency officials and reviewed them for reasonableness and  consistency; we determined that the data were sufficiently reliable for our  purposes. We also interviewed officials from organizations that help  Medicare beneficiaries navigate the Plan Finder website and use Plan  Finder themselves when counseling beneficiaries. We discussed their  experiences with the website, their observations of beneficiaries’  experiences, and any feedback on the website that they have provided to  CMS. While perspectives obtained from these interviews are not  generalizable, they provided insights into users’ perspectives on Plan  Finder. We compared CMS’s processes for obtaining feedback on Plan  Finder’s usability to leading practices for collecting feedback and   We discussed these data  performance data on website usability provided on HowTo.gov, a source  of information for federal website development and management.
We conducted this performance audit from July 2013 to January 2014 in  accordance with generally accepted government auditing standards.  Those standards require that we plan and perform the audit to obtain  sufficient, appropriate evidence to provide a reasonable basis for our  findings and conclusions based on our audit objectives. We believe that  the evidence obtained provides a reasonable basis for our findings and  conclusions based on our audit objectives.
subsections: section_title: Background
paragraphs: Medicare Part D was established by the Medicare Prescription Drug,  Improvement, and Modernization Act of 2003.beneficiaries have been able to obtain prescription drug coverage through  prescription drug plans offered by Part D plan sponsors that contract with  CMS. Plan sponsors offer prescription drug coverage through stand-alone  prescription drug plans (PDP) or through Medicare Advantage  prescription drug plans (MA-PD), which combine medical and prescription  drug benefits. In 2013, CMS had 75 PDP and 555 MA-PD contracts with  Part D plan sponsors that together offered 2,660 plans. About 64 percent  of beneficiaries with a Part D plan enrolled in PDPs and 36 percent  enrolled in MA-PDs.
subsections: section_title: Part D Benefits and Costs
paragraphs: Part D plan sponsors are required to offer plans that provide a minimum  set of benefits to beneficiaries—the standard benefit—or an actuarially  equivalent benefit. Under the standard benefit, beneficiaries pay  monthly premiums and cost-sharing for drug purchases. Cost-sharing  varies over the course of the year as beneficiaries move through the  phases of the benefit. The standard benefit features a deductible and an  initial coverage period during which beneficiaries pay coinsurance for  prescription drugs until they reach the initial coverage limit. After the initial  coverage period, beneficiaries enter the coverage gap, which is followed  by the catastrophic coverage period in which beneficiaries pay a small  share of total drug costs (see fig. 1).
In addition to the standard Part D benefit, plan sponsors can offer a range  of plans with different benefit structures that are actuarially equivalent to,  or exceed the standard benefit. Under these plans, monthly premiums  and cost-sharing arrangements can vary. For example, plans with  enhanced benefits may charge higher monthly premiums than standard  benefit plans, but may offer lower cost-sharing arrangements, such as a  reduction or elimination of a deductible. Under Part D, certain individuals  are also entitled to a low-income subsidy (LIS), through which they get  reduced premiums and generally have zero or nominal cost-sharing.
Subject to certain rules, the prescription drugs covered by Part D plans  and the cost-sharing arrangements for covered drugs may differ between  plans. Each Part D plan has a formulary—a list of the prescription drugs  that it covers and the terms under which they are covered. While each  plan may vary in the specific drugs it covers, plans must adhere to a  minimum set of formulary requirements established in statute and  regulation. In addition, a plan’s formulary may assign drugs to tiers that  correspond to different levels of cost-sharing. For example, plans often  assign generic drugs to the tier that requires the lowest cost-sharing level.  Plans have flexibility in how they structure tiers, and different plans may  place the same drug in different tiers. Plans may also subject drugs to  utilization management practices, such as a limit on the amount of a drug  that is covered.
Part D cost-sharing for beneficiaries may also vary based on the  pharmacies they use. Plan sponsors contract with retail and mail order  pharmacies to dispense the drugs that plans cover. Plan sponsors  negotiate the prices for covered drugs with pharmacies, and may  negotiate different rates with different pharmacies. Some plans have  “preferred” pharmacies within their pharmacy network that have agreed to  offer drugs at lower cost-sharing levels.
section_title: The Medicare Plan Finder
paragraphs: Since the beginning of the Part D program, CMS has administered the  Plan Finder website to assist beneficiaries and their advisers in assessing  Part D plan options by providing them with information on plan coverage  and quality, and by estimating their annual drug costs. Beneficiaries can  use Plan Finder to evaluate their plan options when they first become  eligible for Part D or to reevaluate their options during the open  enrollment period each year, and they can enroll in a plan through the  website. To compare plans in Plan Finder, beneficiaries work their way  through the website by entering information on where they live, the drugs  they take, and the pharmacies they use. Plan Finder then identifies Part D  plan options available to them and estimates their annual drug costs for  each plan at their selected retail and mail order pharmacies (see fig. 2). It  also provides information on how beneficiaries’ monthly drug costs  change as they move through the Part D benefit over the course of the  year. In addition to the website, customer service representatives for   1-800-MEDICARE—a nationwide toll-free telephone help line that  beneficiaries and their advisers can call to ask questions about  Medicare—also use a version of Plan Finder to provide information on  Part D plan options and to enroll beneficiaries over the phone.
section_title: CMS Oversight of the Part D Program
paragraphs: CMS is responsible for overseeing plan sponsors’ compliance with their  Part D contracts. CMS imposes program requirements on Part D plan  sponsors—including a requirement that they submit accurate drug price,  formulary, and pharmacy network information for Plan Finder—and  sponsors are subject to possible compliance and enforcement actions for  failure to meet those requirements. In addition, compliance and  enforcement actions are included in the plan sponsor’s record of past  performance, which CMS considers when reviewing applications for new  or expanded Medicare contracts submitted by that plan sponsor.
CMS can impose a range of compliance and enforcement actions to  ensure compliance with program requirements, including requirements  related to Plan Finder. The lowest-level compliance action is a notice of  noncompliance, which notifies the Part D plan sponsor that it is in  violation of program requirements under the terms of one or more of its  contracts. The notice of noncompliance requests that the plan sponsor  address the problem. If the noncompliance continues, CMS may issue a  warning letter. significant number of beneficiaries, represents an ongoing or systemic  inability to adhere to program requirements, or is particularly egregious,  CMS may require the plan sponsor to develop and implement a corrective  action plan. The corrective action plan must address the deficiencies  identified by CMS, provide an attainable time frame for implementing  corrective actions, and include a process for validating and monitoring  that the corrective actions were taken and remain effective. CMS can also  take enforcement actions for persistent noncompliance or to address  more significant violations. Enforcement actions include civil money  penalties; marketing, enrollment, and payment suspensions; and contract  terminations. The nature of each instance of noncompliance is considered  when determining the appropriate compliance or enforcement actions,  and the actions generally proceed through the process in a step-by-step  manner. However, for more serious violations, CMS may choose to  immediately proceed to later-stage compliance or enforcement actions.
In some instances, CMS may request in the warning letter that the sponsor submit a  business plan for resolving issues related to the noncompliance.
CMS also oversees the Part D program through its Star Ratings, which  assigns scores to Part D contracts every year across a range of quality  measures. CMS collects performance data on Part D plans covered  under each individual contract for 18 quality measures—including a  measure for Plan Finder drug pricing accuracy. CMS aggregates these  quality measure scores and assigns an overall quality score between one  and five stars, with five being the highest, to each contract. Each  contract’s overall score and individual quality measure scores are applied  to all plans covered under the contract, and CMS posts plans’ scores on  the Plan Finder website to help beneficiaries choose high-quality plans.CMS also considers Star Ratings performance when reviewing sponsors’  applications for new or expanded Medicare contracts.
section_title: CMS Uses Data Checks and Quality Measures to Oversee Plan Finder’s Drug Pricing Accuracy and Has Taken Compliance Actions against Plan Sponsors
paragraphs: To assess the accuracy of pricing information on Plan Finder, CMS  performs computerized data checks on pricing information before it is  displayed on Plan Finder and has taken compliance actions against  certain Part D plan sponsors for submitting inaccurate and incomplete  pricing information. In addition, CMS uses quality measures to  retrospectively evaluate the accuracy of pricing information on Plan  Finder.
subsections: section_title: CMS Uses Data Checks and Compliance Actions to Oversee Drug Pricing Accuracy
paragraphs: CMS performs computerized data checks to identify incomplete and  potentially inaccurate pricing information before it is posted to Plan  Finder. CMS requires Part D plan sponsors to submit drug pricing  information for their plans on a biweekly basis—which Plan Finder uses to  estimate beneficiaries’ cost-sharing amounts and expected drug costs. In  2013, CMS performed a set of over 25 data checks on the biweekly  submission for each plan, including checks to identify outlying drug prices  significantly higher or lower relative to the prices submitted by other plans  and checks to identify missing data.
If CMS’s data checks identify potentially inaccurate plan pricing  information, CMS notifies the sponsor of the plan and gives the sponsor  an opportunity to attest to the accuracy of the data, or correct it. If the  sponsor does not verify or correct the pricing information, CMS will  “suppress” the plan from Plan Finder for two weeks, or longer if the  sponsor does not provide accurate pricing information for the next  biweekly data update. When a Part D plan is suppressed from Plan  Finder, its pricing information is removed and beneficiaries cannot enroll  in the plan through the website. Plan Finder displays a warning notice  alerting beneficiaries that the plan’s pricing information is unavailable and  that they must contact the plan directly for cost information as well as to  enroll. In 2012, 18 percent of Part D contracts had one or more plans that  were suppressed from Plan Finder at least once, and, from January 1,  2013, through July 31, 2013, 25 percent of contracts had one or more  plans that were suppressed at least once (see table 1).
In addition to these quality assurance checks, CMS officials noted that  they may identify Plan Finder pricing inaccuracies based on feedback  provided by beneficiaries and organizations that provide assistance to  beneficiaries, such as the State Health Insurance Assistance Programs  (SHIP).  According to CMS officials, SHIPs and other stakeholders can  report inaccurate prices or other concerns through a Plan Finder email  inbox maintained by CMS, and beneficiaries can report inaccuracies  through 1-800-MEDICARE.
SHIPs are state agencies that provide counseling and assistance to Medicare  beneficiaries. noncompliance and 67 warning letters for inaccurate or incomplete drug  pricing information.
According to CMS documents, there has only been one instance in which  CMS required a Part D plan sponsor to develop and implement a  corrective action plan for compliance concerns related to Plan Finder  pricing accuracy. CMS required this corrective action plan in 2008 after it  found ongoing discrepancies between a plan’s drug prices submitted to  Plan Finder and the prices beneficiaries paid at the point-of-sale. CMS  found the discrepancies so egregious that the agency referred the issue  to the Department of Justice. In 2012, the plan sponsor entered into a civil  settlement agreement with the federal government to resolve allegations  that the plan sponsor submitted false pricing information in 2007 and  2008.
CMS’s processes for overseeing the accuracy of drug pricing information  in Plan Finder are consistent with internal control standards for the federal  government. These standards specify that agencies should have  processes in place to oversee the accuracy of data and that they should  design and implement controls and processes to ensure that ongoing  monitoring occurs in the course of normal operations.
section_title: CMS Uses Quality Measures to Evaluate Pricing Accuracy
paragraphs: CMS’s Star Ratings, which provide beneficiaries with information on plan  quality, assigns scores to each Part D contract on the accuracy of pricing  information on Plan Finder. To determine the annual quality ratings for  drug pricing accuracy, CMS compares Plan Finder drug prices with  beneficiaries’ point-of-sale drug costs and assigns scores based on the  extent to which the point-of-sale costs were higher than prices posted on  Plan Finder. For the 2013 Star Ratings, 6 percent of contracts had  point-of-sale prices that were greater than Plan Finder prices by an  average of 4 percent or more. This is a decrease from 13 percent of  contracts in 2011 (see table 2).
CMS officials stated that the Star Ratings drug pricing accuracy measure  evaluates point-of-sale costs that are higher than Plan Finder prices  because CMS particularly wants to discourage plan sponsors from using  “bait and switch” tactics that would encourage beneficiaries to enroll in  plans based on inaccurately low prices. The extent to which point-of-sale  prices are lower than prices posted on Plan Finder are not reflected in the  drug pricing accuracy measure. However, although not part of the Star  Ratings, for 2014 CMS developed an additional “display” quality measure  to track the extent to which point-of-sale costs were lower than prices  posted on Plan Finder. According to CMS, this display measure is intended to discourage plan sponsors from potentially submitting  inaccurate high prices for select drugs or drug classes to discourage  enrollment by certain beneficiaries.
section_title: CMS Has Obtained Feedback on Plan Finder from a Variety of Sources and Has Taken Steps to Improve Usability
paragraphs: CMS has assessed the usability of Plan Finder by obtaining feedback  from a variety of sources and has implemented updates to the website to  improve usability. The practices employed by CMS to obtain feedback on  Plan Finder’s usability are consistent with leading practices identified by  HowTo.gov, which recommends engaging users through surveys, user  testing, and other outreach to collect feedback on usability. Howto.gov  also recommends that agencies collect and analyze performance and  other measures to identify potential improvements to the website’s  organization and content. CMS officials told us that they have obtained  user feedback and web performance data on Plan Finder from the  following sources:
Beneficiary assistance organizations. CMS has obtained feedback on  Plan Finder from SHIPs and other organizations that provide  assistance to Medicare beneficiaries. These organizations help  beneficiaries navigate the website, and their staff often use Plan  Finder when counseling beneficiaries. CMS officials told us that they  hold regular meetings with these organizations and that they maintain  a specific email inbox for SHIP officials and beneficiary advocacy  groups to submit feedback on issues related to Plan Finder. A number  of organizations that we spoke with have provided CMS with  documents detailing suggestions for improving the website. In  addition, several of these organizations noted that CMS has reached  out to them to obtain feedback on planned changes and updates to  the website.
Beneficiary user testing. CMS has conducted user tests on the  usability of Plan Finder with beneficiaries, beneficiary advisers, and  SHIP counselors. The user tests involved interviewing beneficiaries as  they worked their way through Plan Finder to gain insight into their  experiences and any challenges that they faced. For example, the  user tests have analyzed the ease with which beneficiaries can enter  information about the prescription drugs they take and their ability to  use Plan Finder to compare plans. CMS has also conducted user  tests with certain Medicare beneficiary subpopulations. For example,  CMS conducted user tests with LIS beneficiaries to obtain feedback  on their ability to understand LIS-specific information on the website.
A website survey. CMS employs a website customer satisfaction  survey that measures and collects performance data on users’  experiences. For example, the survey asks users to rate the layout  of Plan Finder and the extent to which the website’s design allows  them to find plan information easily. It also asks about the usefulness  of the resources that are available on the website to help users  understand how to use Plan Finder to compare Part D plans. CMS  has tracked several measures that are rated through these surveys,  including measures related to how content is organized and the extent  to which the website streamlines the plan comparison process.
Website user data. CMS tracks Plan Finder website user data, such  as the number of visitors to the website and the amount of time that  users spend on specific webpages, to gain insight into users’  experiences and website navigation patterns. For example, if users  are spending a long time on a specific Plan Finder webpage, it may  indicate that they are having a hard time understanding the  information that is being presented on the page, according to a CMS  official. In addition, CMS officials said that they can also use this data  to measure the number of users that work their way through Plan  Finder to obtain information on Part D plan options available to them.  For those that do not fully work their way through Plan Finder to  obtain information on available plans, CMS tracks user data on when  they exited the website.
CMS has implemented updates to the website on a quarterly basis and,  according to CMS officials, has used feedback on Plan Finder to address  identified issues and improve the website’s usability. For example, CMS  developed and added a “frequently asked questions” webpage to the  website in 2013 to help beneficiaries with frequently encountered issues.  Several of the questions explain how and why cost-sharing can vary  under different circumstances. To help beneficiaries better understand  plans’ pharmacy networks, CMS added an indicator that identifies  whether the pharmacies they entered into Plan Finder are in-network, in- network preferred, or out-of-network in the plans that are available to  them. In addition, CMS has added filters to help beneficiaries compare  Part D plans and select plans that meet their needs. For example, the  filters allow beneficiaries to look only at plans that cover all of the drugs  they take, or plans that have limited premiums or deductibles.
Although CMS has obtained feedback on Plan Finder, incorporating such  feedback and addressing usability issues can present challenges. One  CMS official we spoke with said that incorporating the feedback that CMS  receives can sometimes be difficult since they try to balance the need to  explain complex elements of the Part D benefit, while also keeping the  website streamlined. For example, the official noted that providing too  much information on the website can make it more difficult for  beneficiaries to identify needed information.
Officials from the beneficiary assistance organizations we spoke with  generally told us that Plan Finder helps beneficiaries compare Part D  plans and that the website’s usability has improved over time. However,  certain beneficiaries may face barriers to using Plan Finder, regardless of  the usability of the website. Most of the organizations we spoke with  explained that some beneficiaries have a hard time using the information  provided by Plan Finder to compare plans and identify plans that meet  their needs because of the complexity of the Part D benefit and the  variety of factors that influence cost-sharing. For example, a number of  the beneficiary advocacy groups that we spoke with told us that some  beneficiaries face difficulties understanding why cost-sharing varies  between pharmacies under plans with preferred pharmacy networks. In  addition, certain beneficiaries lack Internet access or do not have  adequate levels of computer literacy to be able to use Plan Finder  independently. Several officials noted, however, that beneficiaries aging  into Medicare eligibility are increasingly experienced in using computers.
Officials from the beneficiary assistance organizations also told us that  beneficiaries enrolling in MA-PDs may have a harder time using Plan  Finder and our analysis of CMS enrollment data found that beneficiaries  enrolling in MA-PDs are less likely to use the Plan Finder website to enroll  than beneficiaries enrolling in PDPs (see table 3). These officials noted  that, in addition to comparing prescription drug benefits, beneficiaries  enrolling in MA-PDs have to identify plans that provide medical coverage  that meet their needs as well. For example, one official we spoke with  said that beneficiaries may not be inclined to enroll in MA-PDs that offer  low cost prescription drug coverage if the beneficiaries’ health care  providers are not in-network.
section_title: Agency Comments
paragraphs: GAO provided a draft of this report to HHS. HHS agreed with GAO’s  findings and provided a technical comment, which GAO incorporated.  HHS’s written comments are reprinted in appendix I.
We are sending copies of this report to the Administrator of CMS. We will  also make copies available at no charge on GAO’s website at  http://www.gao.gov.
If you or your staff have any questions about this report, please contact  me at (202) 512-7114 or KingK@gao.gov. Contact points for our Offices  of Congressional Relations and Public Affairs may be found on the last  page of this report. GAO staff who made key contributions to this report  are listed in appendix II.
section_title: Appendix I: Comments from the Department of Health and Human Services
section_title: Appendix II: GAO Contact and Staff Acknowledgments
subsections: section_title: GAO Contact
paragraphs: Kathleen King, (202) 512-7114, kingk@gao.gov.
section_title: Staff Acknowledgments
paragraphs: In addition to the contact named above, Martin T. Gahart, Assistant  Director; Lori Achman; Michael Erhardt; Cathleen Hamann; Sara Rudow;  and Hemi Tewarson made key contributions to this report.
section_title: Related GAO Products
paragraphs: Managing for Results: Leading Practices Should Guide the Continued  Development of Performance.gov. GAO-13-517. Washington, D.C.:   June 6, 2013.
Consumer Product Safety Commission: Awareness, Use, and Usefulness  of SaferProducts.gov. GAO-13-306. Washington, D.C.: March 11, 2013.
Medicare: Quality of CMS Communications to Beneficiaries on the  Prescription Drug Benefit Could Be Improved. GAO-06-715T.  Washington, D.C.: May 4, 2006.
Medicare: Communications to Beneficiaries on the Prescription Drug  Benefit Could Be Improved. GAO-06-654. Washington, D.C.: May 3,  2006.