Tag Archives for National Council on Aging

Report highlights major flaws, calls for improvements in Medicare Plan Finder

Published in Pawtucket TImes on July 23, 2018

July 23, 2018 | Times, The (Pawtucket, RI)

When shopping around for the best Medicare coverage options in fee-to-service and Medicare Parts C and D, beneficiaries are often told they can rely on the Medicare Plan Finder (MPF) to provide the needed information to compare and choose the plan that best meets their needs. But, a recently released report, co-authored by the Clear Choices Campaign, a health care cost transparency initiative of the Council for Affordable Health Coverage, and the nonprofit National Council on Aging (NCOA), charges that the federal government’s online tool may not be delivering on that promise. “MPF is in the need for significant reform,” advises the report.

MPF Tool Needs a Complete Overhaul

While the 46-page report acknowledges MPF’s “wealth of unbiased information,” it warns that “the status quo is not acceptable, and that a re-tooling of MPF’s plan comparison features and enrollment functions is essential.” “The site is overwhelming, information is poorly presented, and the user design is potentially misleading – all of which confuses beneficiaries and can contribute to many making poor plan selections. Two of the biggest shortcomings are out-of-pocket cost information is difficult to understand and provider directories are difficult to navigate,” concludes the report.

The report’s scorecard gives the MPF “A” grades only for its anonymous browsing capabilities and non-English translation services., but MPF earned “D” or “F” grades in seven other criteria (specifically, Customized Plan Information, Highlights Supplemental Benefits, Integrated Provider Directory, Layout, Access to Human support).

“Modernizing Medicare Plan Finder: Evaluating and Improving Medicare’s Online Comparison Shopping Experience,” released on April 25, 2018, is the result of the first-ever independent stakeholder assessment of MPF. Along with the scorecard rating 12 criteria, the report highlights the evaluation findings and provides specific recommendations to improve MPF.

For its analysis, Clear Choices and NCOA staff undertook a detailed review of all online MPF functions, conducted 25 interviews with Medicare beneficiaries, and surveyed Medicare State Health Insurance Assistance Program (SHIP) directors, who routinely use the tool in assisting millions of Medicare beneficiaries. The findings highlight a number of MPF challenges for beneficiaries, ranging from the unavailability of human support, to language that is unfamiliar to the typical consumer, to confusing out-of-pocket cost estimates.

“In order for competition to work in the increasingly complex Medicare program, beneficiaries must be well-informed and have consumer-friendly tools available to make wise plan choices,” said Howard Bedlin, NCOA’s Vice President of Policy and Advocacy. “I sat with seniors and talked with them while they struggled to use the Plan Finder and I can assure you, this is clearly not the case today. This report includes 11 key and 25 detailed recommendations for making this goal a reality, and ensuring that every beneficiary has access to the information they need to make the best Medicare decision for their situation. NCOA, and the diverse groups and thought leaders who contributed to this report stand ready to help make it happen.”

Joel White, Clear Choice’s president, says “our members know that transparency is key to unlocking greater competition and to ultimately drive down healthcare costs.”

Markets respond when consumers are empowered to make informed decisions by using tools to compare their options, he says.

“Sadly, in this case, a tool designed to help beneficiaries better understand their choices is failing in its mission and adding to the confusion and opaqueness that typifies too many Americans’ healthcare experience. We must fundamentally re-imagine how MPF delivers information to consumers and, ultimately, have an honest conversation about whether beneficiaries would not be better served by the private sector,” adds White.

“Medicare beneficiaries need to be able to understand and compare their Medicare options so they can choose the plan that is best for them. We hope that CMS will implement the recommendations in the report in order to improve MPF’s consumer-facing features,” says Karin Bolte, senior director of health policy, National Consumers League,

Creating a Better Online Consumer Tool

The report includes 11 key and 25 detailed recommendations that NCOA and Clear Choices believe will improve the Medicare Plan Finder and ensure that every beneficiary has access to the information they need to make the best Medicare decision for their situation.

These include:

• Displaying costs with decision and prominence

• Basing estimated out-of-pocket costs on more detailed information

• Integrating a provider directory

• Utilizing saved information about consumers’ drugs

• Allowing consumers to compare Medicare Advantage plans with an equivalent combination of fee-for-service, Medigap, and standalone drug plans

• Redesigning the layout and display to enhance usability and promote intuitive navigation

• Replacing insurance jargon with graphics, charts, and plain language

• Integrating a web chat feature

• Enabling the website to suggest plan options

• Contracting to ensure more stringent oversight of MPF’s accuracy

• Testing the site with consumers on a regular basis

With 10,000 Baby Boomers enrolling in Medicare every day, its crucial for the U.S. Centers for Medicare and Medicaid Services to closely review the “Modernizing Medicare Plan Finder” report’s recommendations and make appropriate changes for this online tool to remain relevant. To access the report, go to http://www.ncoa.org/wp-content/uploads/CC-2018-MedicarePF- Report-Final-0418.pdf.

Trump Budget Proposal Makes Draconian Cuts to Aging Programs

Published in Woonsocket Call on March 19, 2017

Since his inauguration, GOP President Trump/s controversial and surprising Cabinet picks, some who have even called for the elimination of federal agencies that they were appointed to oversee, has sent a chilling message to the nation. That is business as usual is over inside the Washington Beltway, especially as to how federal dollars will be spent. The release of Trump’s first budget proposal, for fiscal year 2018, reveals draconian cuts throughout the federal government, this causing alarm among aging advocacy groups.

Trump Slashes Funding for Aging Programs and Services

James Firman, President and CEO, of the Washington, D.C.-based National Council on Aging (NCOA), notes Trump’s 62 page $.15 trillion budget proposal to remake the nation’s federal agencies and the programs they provide eliminates the Senior Community Service Employment Program (SCSEP), which provides job training and placement for adults 55 and over who have limited incomes and are trying to make ends meet. “Last year under SCSEP, 70,000 older adults received on-the-job training while providing nearly 36 million hours of staff support to 30,000 organizations, he says, noting that the value of this work exceeded $800 million, or nearly twice the program’s appropriations.

Trump’s budget proposal also zeros out the Low-Income Home Energy Assistance Program (LIHEAP), which provides assistance to low-income households to meet the costs of electricity, heating, and cooling, says Firman, noting that about a third of the nearly 7 million households receiving LIHEAP benefits include an older adult aged 60 or older.

Finally, Trump’s budget proposal eliminates the Corporation for National and Community Service (CNCS), which funds volunteer programs that serve distressed communities and vulnerable population, says Firman, noting that three Senior Corps programs (the Foster Grandparent Program, Senior Companion Program, and Retired Senior Volunteer Program (RSVP), will lose funding. “Together, these programs provide the nation with approximately 96 million hours of service, with a value of $2.1 billion,” he says.

“While the President’s budget blueprint does not cut Social Security Administration (SSA) funding (unlike the drastic reductions in non-defense discretionary spending), the 0.2% increase for SSA does little to solve serious customer service deficiencies for Social Security beneficiaries,” says Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare (NCPSSM). “Seven years ago, the SSA’s budget was cut by 10% (after adjusting for inflation), just as waves of Baby Boomers were beginning to retire and place a strain on the agency’s resources,” he says.

Richtman noted that while the numbers of Social Security beneficiaries were increasing, SSA was forced to implement a hiring freeze in 2016 and was not able pay its workers overtime. As a result, hold times on the SSA toll-free customer service number are now an average 15 minutes, more than 60 SSA field offices around the country have been shuttered, and the average wait time for a disability hearing has climbed up to 590 days.

Richtman points out that one million people are awaiting their scheduled disability hearing. “The disability case backlog and customer service will only get worse under the flat operating budget proposed by the President. To make up for previous cuts and restore vital services, the National Committee supports a 7% increase in the SSA’s operating budget,” he says.

NCPSSM’s Richtman warns that Trump’s “skinny budget” may keep millions of vulnerable seniors from participating in the Meals on Wheels program. As Meals on Wheels America has pointed out, Trump’s budget blueprint eliminates the U.S. Department of Human Development’s (HUD) Community Services Block Grant and Community Development Block Grant (CDBG), on which some local Meals on Wheels programs rely on to deliver nutritious meals, safety checks, and friendly visits to seniors who need these services. (The President’s budget blueprint does not mention the Older Americans Act, which provides 35 percent of Meals on Wheels funding nationally.)

Richtman calls on President Trump to ride along with a Meals on Wheels delivery van and see for himself how seniors thrive on the meals they receive and the much-needed human interaction that comes with the food. “Maybe then he would move to protect – rather than cut – this vital program for our nation’s seniors,” he says.

Budget Proposal Puts Food Delivery Program on Budgetary Chopping Block

Trump’s elimination of HUD’s CDBG program in his proposed budget proposal will drastically impact many Meals on Wheels programs across the nation, but, fortunately Meals on Wheels of RI (MOWRI) will not be hit as hard, says Heather Amaral, executive director of Meals on Wheels of RI. But, Rhode Island’s only non-profit home-delivered meal program, will be indirectly impacted by Trumps CDBG cuts, she worries, noting that other programs that support her work receive these HUD funds, specifically, community centers that house our Capital City Café sites or local drop-off sites for the Home Delivered program. The Senior Community Service Employment Program that provides staff for several of our Café sites is also slated for elimination in President Trump’s “Skinny Budget.”

Amaral also is concerned about Trump cutting the U.S. Department of Health and Human Services’ budget by 18 percent. “Our Older Americans Act Title III funding flows through this department. It is safe to assume that this significant cut will result in a reduction of our funding—funding that has remained at stagnant for over 10 years,” she says.

“It is impossible to predict any service cuts until a final federal budget is approved and any cuts to MOWRI are known. Any funding reductions will have a negative impact on her nonprofit agency’s ability to keep up with the increased demand of Rhode Island’s growing senior population,” says Amaral.

“Our programs directly address issues that are critical to Rhode Island’s vulnerable homebound seniors,” she says, noting that last year, MOWRI delivered 345,262 meals to over 2,560 homebound residents.

Last Thursday, White House budget director Mick Mulvaney defended the Trump budget proposal cuts to the widely popular Meals on Wheels program. He told reporters that the program “sounds great” but is “not showing any results.”

Amaral counters by saying that research is providing the tremendous benefits of participating in the meals and wheels program — for seniors, homebound, family members, municipalities and the Rhode Island

The Brown University “More than a Meal” Report (published 2015), a randomized, controlled study of Meals on Wheels Programs across the country, reported that those who received daily-delivered meals experienced the greatest improvements in health and quality of life indicators,” says Amaral. The most vulnerable of our recipients, those who live alone, were more likely to report decreases in worry about being able to remain in home and improvements in feelings of isolation and loneliness, she noted.

Meanwhile, a U.S. Administration on Aging (AoA) Study, published in September 2105, found that those receiving daily-delivered meals are more likely to report improvements in mental and physical health, reductions in feelings of isolation and anxiety about being able to remain at home, and lower rates of hospitalization and falls, adds Amaral.

“In that same report, AoA statistics show that a home delivered meal program can deliver a year’s worth of meals to a senior for the same cost as one day in the hospital, or one week in a nursing home, notes Amaral.

Speaking at the Hubert Humphrey Building dedication in Washington, D.C. on November 1, 1977, former U.S. Vice President (1965-69) Hubert Humphrey stated “the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped.” A quick read of the Trump’s budget proposal revealing huge cuts for domestic programs, it’s clear to many that his Administration has failed it’s test.

If you want to learn more about MOWRI, sign up for meals, volunteer or donate, please visit http://www.rimeals.org or call 401-351-6700.

Aging Groups Consider Obama’s Fiscal 2014 Budget Proposal a “Mixed Bag”

Published in Woonsocket Call, April 21, 2013

President Barack Obama, missing the federal mandated budget submission deadline by over two month, finally unveils his fiscal blueprint on April 10, giving Capitol Hill a peek as to how he would fund the nation’s federal agencies, programs and services.

The President proposed a $3.8 trillion budget plan for fiscal 2014, that seeks to slash the huge federal deficit by a net $600 billion over 10 years, raises taxes on the wealthy, and puts the breaks to rising costs of two very popular senior programs, Social Security and Medicare.

Senior groups call President Obama’s the first budget proposal of his second presidential term, a “mixed bag.” His fiscal blueprint would eliminate the draconian cuts of the sequester, that is the arbitrary, across the board cuts Congress imposed this year. However, Obama seeks to reduce the federal deficit by calling for another $200 billion in cuts to discretionary programs – half from defense programs and half from domestic programs.

Braking the Rising Costs of Social Security Despite the Social Security Trustee’s 2012 Annual Report that the entitlement program has the financial resources to pay all benefits through 2033 (see my June 1, 2012 Commentary in Pawtucket Times), Social Security benefits are targeted in the recently released budget plan for substantial cuts by adopting the “chained” consumer price index (CPI) for the purpose of calculating Social Security cost-of-living adjustments, or COLAs.

According to the Washington, D.C.-based, National Committee to Preserve Social Security and Medicare (NCPSSM), the Obama Administration sees this switch as “a technical adjustment.” Aging group warn that using the “chained” CPI will substantially reduce the Social Security benefits of current and future beneficiaries. “If it is adopted, a typical 65 year-old would see an immediate decrease of about $130 per year in Social Security benefits. At age 95, the same senior would face a 9.2 percent reduction—almost $1,400 per year,” notes NCPSSM.

While all beneficiaries will feel the impact of this change, its effect will be greatest on those who draw benefits at earlier ages (e.g., military retirees, disabled veterans and workers) and those who live the longest, says NCPSSM, especially “women who have outlived their other sources of income, have depleted their assets, and rely on Social Security as their only lifeline to financial stability.”.

With Republican Congressional lawmakers generally supportive of Obama’s push to rein in Social Security costs, through the use of the “chained” CPI, liberal Democratic lawmakers, including Rep. David Cicilline, representing Rhode Island’s 2nd Congressional District, strongly oppose the President or any Congressional efforts to cut Social Security to lower the nation’s federal deficit.

Rep. Cicilline calls for reforming the nation’s tax code by ending subsidies for “Big Oil,” along with “making responsible target spending cuts,” to slash the nation’s huge federal deficit .

AARP Poll Says, Keep Your Hands Off Social Security
In a statement, AARP Executive Vice President Nancy A. LeaMond, quickly reacted to the Democratic President’s efforts to use the “chained” CPI to control rising Social Security program costs.

While AARP recognizes the need for the President and Congress to confront budget challenges facing the nation, the nation’s largest aging advocacy group calls for “responsible solutions, not harmful proposals” that would hurt older beneficiaries or threaten the retirement security of the generations that follow, says LeaMond.

LeaMond said, “AARP is deeply dismayed that President Obama would propose cutting the benefits of current and future Social Security recipients, including children, widows, veterans and people with disabilities, to reduce the deficit. Social Security is a self-financed program that doesn’t contribute to the deficit, so it shouldn’t be cut to reduce it.”

AARP’s polls indicated that older Americans, across the political spectrum, agree with nonprofit group’s opposition to the “chained” CPI. LeaMond, notes. The recently released national survey found that “fully 84% of voters age 50 and over oppose cutting Social Security benefits to reduce the deficit.”

“Instead of making harmful cuts to Medicare or shifting additional costs onto beneficiaries, we need to look for savings throughout the health care system, including Medicare,” suggests LeaMond. She says that also “lowering the costs of prescription drugs, innovations that promote better care, reward improved outcomes and make health care programs more efficient and less wasteful have the potential to hold down systemic high health care costs, including costs in Medicare.”

Finally, LeaMond adds, “We know that prescription drugs are one of the key drivers of escalating health care costs, so we appreciate the President’s inclusion of proposals to find savings in lower drug costs. And we applaud his plan to accelerate closure of the ‘donut hole’ in Medicare Part D by 2015, which would reduce seniors’ often burdensome out-of-pocket health care expenses.”

A Snap Shot of Other Aging Budget Issues
Howard Bedlin, Vice President for Public Policy and Advocacy at the National Council on Aging (NCOA), in a written statement calls Obama’s budget proposal a “mixed-bag” when it comes to seniors.”

Bedlin acknowledges that the recently released Obama budget eliminates the sequester cuts to critical programs like Meals on Wheels and other Older Americans Act services, elderly housing, and other vital senior services. “It is unfortunate that cuts are proposed for low-income energy assistance and senior job training and placement programs,” he says.
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According to Bedlin, the President’s budget also protects SNAP (Food Stamps) and Medicaid, in sharp contrast to the drastic cuts approved in the Republican-controlled House budget proposal. “Cuts in Medicaid would be devastating to the millions of vulnerable seniors who rely on the program for long-term care and Medicare low-income protections,” he says.
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Meanwhile, a major concern for NCOA with the President’s budget surrounds Medicare and Social Security. While the organization supports some of the Medicare reductions, the proposed $370 billion in additional cuts are “excessive and several will harm” beneficiaries (more than half having incomes below 200 percent of the poverty line), says Bedlin, these cuts in addition to the $716 billion in Medicare cuts under health reform and significant reductions in spending growth over the past three years.

Also, the proposed new home health co-payment will fall primarily on lower-income older women with multiple chronic health conditions, and lead to premature nursing home placement, predicts Bedlin. “The proposed increase in the Medicare Part B deductible would be especially harmful and unaffordable to millions of seniors with incomes just above the federal poverty line ($958 per month),” he says.

Finally, Bedlin notes that the proposed Medigap surcharge would penalize seniors for decisions made by their doctors, cause major market disruption, and seriously confuse many current policy holders. The proposal to further increase Medicare premiums based on income could result in those with incomes of about $47,000 being forced to pay more.

NCOA joined AARP and NCPSSM and virtually every other national aging organization in opposing the President’s proposal to cut the Social Security Cost of Living Adjustment (COLA) through the use of a “chained” CPI.

A Final Note… With Obama’s proposed budget now thrown in the ring with the House and Senate budgets already drafted and voted on, will Congressional gridlock keep the Democratic President, the GOP-Controlled House and Democratic Senate from working together to hammer out a consensus, bipartisan compromise? Only time will tell if elected lawmakers clearly get the message from the American people, “put the people first and not your political party.”

Herb Weiss, LRI ’12, is a Pawtucket-based freelance writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.