Projects

Improving Beneficiaries’ Medicare Experience

How can Medicare better communicate with Americans about their health choices?

Partners & Funders

The Project

Four times a year, 40 million Americans are sent a summary of their Medicare coverage, updating them on their claims, bills, and available services. PPL partnered with the US federal government to leverage this communication as a tool to empower Americans about their health choices.

The Outcome

After conducting interviews with beneficiaries in 15 towns across America, we developed a more accessible, engaging, and informative Medicare Summary Notice. The new document incorporates a ‘dashboard’ with critical information in one spot, a checklist for free preventive care, features to fight fraud and claim errors, an easy appeals form, and other beneficiary-friendly features.

Improving Beneficiaries’ Medicare Experience

How can Medicare better communicate with Americans about their health choices?

Partners & Funders

The Project

Four times a year, 40 million Americans are sent a summary of their Medicare coverage, updating them on their claims, bills, and available services. PPL partnered with the US federal government to leverage this communication as a tool to empower Americans about their health choices.

The Outcome

After conducting interviews with beneficiaries in 15 towns across America, we developed a more accessible, engaging, and informative Medicare Summary Notice. The new document incorporates a ‘dashboard’ with critical information in one spot, a checklist for free preventive care, features to fight fraud and claim errors, an easy appeals form, and other beneficiary-friendly features.
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Hours of user interviews

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Rounds of design research conducted

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Towns engaged for user research

Project Background

In 2010, the firms of PPL founders David Gibson, Chelsea Mauldin, and the late Sylvia Harris participated in an evaluation of Medicare communications. Their preliminary goal was to identify ways to improve Medicare beneficiaries’ engagement and informed decision-making during the enrollment process, with a special focus on how to help beneficiaries compare and choose Part C and Part D coverage. Unlike “Original Medicare,” which is directly administered by the government, Part C and D healthcare and prescription drug plans are offered by third parties, under contract to the government. As many as 30 or 40 different private-sector plans may be available in a given region. Beneficiaries, overwhelmed by multiple options, often default to plans with familiar names or low-up-front premiums, rather than plans offering greater financial or health value. Medicare hoped to find ways to make this process more clearer and easier for beneficiaries.

We conducted an exhaustive audit of existing communication materials and studied information architecture and usability best practices to inform our final recommendations. 

What We Found

Working closely with public-research firm KRC Associates, Public Policy Lab’s design team carried out in-depth interviews with leadership at the Centers for Medicare and Medicaid Services and external subject-matter experts and performed an extensive review of related academic literature. The team then conducted more than 160 hours of user interviews in 15 towns, over five rounds of design research, testing new materials each round. 

The project team found that communications material looked professional, but not consistent; that it was easy for beneficiaries to get lost in the Medicare process; that the complex and punishing process undermined beneficiary engagement, confidence, and rational choice; and finally, that no agency-wide system existed to coordinate messaging, branding, and/or user experience.

During workshops, the project team walked partners through beneficiaries’ experience with a plethora of digital, print, and third-party resources. 

What We Designed

CMS subsequently engaged us to redesign the Medicare Summary Notice, the quarterly communication sent to nearly 40 million ‘Original’ Medicare beneficiaries across the country. Based on research and prototype testing, PPL redesigned a simpler and more navigable communication tool that included user-friendly messaging, language, and graphics, aimed at improving functional factors (choice-making) and experiential factors (ease, trust, reward).

PPL also provided long-term recommendations for CMS to conduct user-experience research, rebrand themselves, improve data systems, and strengthen external partnerships; as well as short-term recommendations to build a Medicare choice diagram and a choice checklist. 

Our final design for the Medicare Summary Notice incorporates a ‘dashboard’ with critical information in one spot, a checklist for free preventive care, an easy appeals form, and other beneficiary-friendly features. This new health claims document helps combat billing fraud, while also better engaging and informing Americans about their Medicare benefits. 

What is New on Your Redesigned "Medicare Summary Notice"?

Our design recommendations for clearer and more navigable communications are featured in this overview of changes to the Medicare Summary Notice. PDF courtesy of CMS. 

Project Implementation

The redesigned Medicare Summary Notice won a 2012 ClearMark Award of Distinction from the Center for Plain Language and began rolling out to the public in mid-2013.

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