June 1, 2009 â March 31, 2011
TO: MIPPA Grantees FROM: National Center for Benefits Outreach and Enrollment DATE: July 22, 2011 RE: MIPPA Grantee Quarterly Report (January 2011 –March 2011)
OVERVIEW: Figure 1: Summary of Applications Submitted by Year (June 1, 2009 – March 31, 2011) APPLICATION TYPE
2009
2010
2011
Total
TOTAL VALUE OF BENEFITS
LIS
46,221
116,384
29,997
192,602
$765,785,900
MSP TOTAL*
31,143
86,092
23,732
140,967
$209,729,054
77,364
202,476
53,729
333,569
$975,514,954
*Includes Wisconsin SeniorCare 1 SPAP enrollments
Since June 2009, MIPPA grantees have: Submitted 192,602applications for the Part D Low-Income Subsidy. Submitted 140,967 applications for the Medicare Savings Programs, many of which were full Medicaid applications. Completed 128 percent of their first MIPPA grant two-year goal in the first 15 months of the grant, and 28 percent of their second MIPPA grant two-year goal. Helped individuals apply for close to $1 billion in LIS and MSP benefits alone, contributing to greater access to health care and economic security and strengthening the economies in their communities. In 2010, the 116,384 LIS applications submitted by MIPPA grantees reduced the number of people missing out on LIS by 7.3 percent. In several states (Alaska, Illinois, Maryland, Montana, New Mexico), the gap has been closed by more than 20 percent.
GRANTEES’ PROGRESS Between January 1, 2011 and March 31, 2011, 29,997 LIS applications and 23,732 MSP applications were submitted on behalf of low-income seniors and younger adults with disabilities, providing them with nearly $157 million in benefits.1 The applications submitted during this quarter raise the total cumulative number of application to 333,569 and the total value of benefits to nearly $1 billion.
Figure 2: Cumulative Number of LIS and MSP Applications by Quarter Total: 333,569
340,000
23,732
320,000 300,000
Total: 279,840
280,000
24,039
260,000 240,000
Total: 221,506
220,000 200,000
Total: 185,473 21,828
180,000 160,000
Total: 138,693
140,000 120,000
24,077
100,000
37,252
Total: 77,364
0
16,148 19,885
24,952
279,840
Total: 27,317 12,485 14,832 Jun to Sep 2009
31,389
185,473 138,693
18,658
60,000 20,000
34,295
221,506
80,000 40,000
29,997
77,364
27,317 Oct to Dec 2009
Jan to Mar 2010
Apr to Jun 2010
Applications from Previous Quarters
Jul to Sep 2010
New LIS
Oct to Dec 2010
Jan to Mar 2011
New MSP
Source: National Council on Aging, BenefitsCheckUp.org MIPPA Reporting System, (June 1, 2009 to March 31, 2011)
1
The total value of benefits is obtained by multiplying the number of applications by the annual value of each benefit. According to the Social Security Administration, the annual value of the Low-Income Subsidy in 2011 is $4,000. The annual value of the Medicare Savings Programs is the weighted average value of QMB, SLMB and QI in 2011. Based on NCOA’s BenefitsCheckUp.org data, the weighted average value of these programs is $1,574.73. In the District of Columbia where there are no SLMB and QI programs, the estimated annual value of MSP is $1,792.
2
Several states reported significant increases in their number of LIS and MSP applications submitted during this quarter. In absolute terms, Florida, Illinois, and New York had the highest increase in applications, with over 4,000 applications submitted during the past quarter. As of March 31, 2011, Illinois and New York had submitted the highest total number of LIS and MSP applications since June 2009. Both states lead the nation in absolute number of applications primarily due to the size of their Medicare eligible population and also their ability to leverage the enrollment in their state pharmaceutical assistance programs. Two groups of states reported the highest percent growth in applications during this quarter. The first group is made up of the new MIPPA grantees of Delaware and Wyoming. These states showed the strongest performance. The second group of states is made up of the states that had a late start in MIPPA 2009 or that struggled to meet their goals at earlier stages of the MIPPA grant (Hawaii, Nevada, Michigan, Texas, and Virginia). These states reported increases above the national average of 19 percent. The efforts of this most recent quarter helped the District of Columbia, Kentucky, Louisiana, Missouri, New Jersey, and Virginia to achieve 100 percent of their 2009 MIPPA goal. These states will join the 34 states that completed their 2009 goal and are now working toward the completion of their 2010 MIPPA goals. Seasonality in MIPPA Data After seven quarters of reported data, the cumulative data provides a picture of trends and seasonality in MIPPA efforts. Figure 3 shows the number of LIS and MSP applications by quarter since June 2009. As expected, MIPPA enrollment efforts show a seasonal pattern that aligns with the annual enrollment period for Part D (October to December) and Medicare Advantage open enrollment period (January to March), which typically have the highest number of contacts between counselors and Medicare beneficiaries. MIPPA efforts have been consistent during these periods, yielding over 50,000 LIS and MSP applications. The data also shows that with one exception (January to March quarters in 2010 and 2011), MIPPA efforts have improved over time when compared to similar quarters in previous years. The data provides further evidence that supports two trends that were discussed in an earlier MIPPA report. 2 The first trend shows a decreasing gap between the number of LIS and MSP applications. This trend is the result of (1) the growing number of states that secured a data-sharing agreement with their state Medicaid office to process the LIS data that is sent by SSA; (2) an increasing number of local MIPPA partners who are for their first time completing and submitting MSP applications despite the relative challenges of these applications; and (3) the improved accuracy in counting and reporting the individuals who are helped with an MSP application, specially individuals for whom a full Medicaid application was submitted. These trends will continue in future quarters as a result of a new reporting policy established by AoA, CMS and NCBOE that encourages grantees to provide follow-up and troubleshooting on MSP applications that are denied by the state Medicaid agency. Another pattern observed in the data relates to the effects of the second MIPPA grant. In an earlier report, we noticed that “[ t]here is marked slowdown in the states that have achieved 100 percent of their 2009 goal [prior to June 30, 2010]. On average, states that achieved their goals [prior to June 30, 2010] reported a 17 percent increase in submissions. In contrast, the remaining states reported a 34 2
See page 3 of NCBOE, MIPPA Grantee Quarterly Report (June 2010 to September 2010) released on December 10, 2010.
3
percent increase in submissions.” However, Figure 3 shows that the second MIPPA grant provided a new impetus to MIPPA efforts that reversed the observed trend. The October to December 2010 quarter showed the largest growth in applications seen since the beginning of MIPPA in 2009. This growth was driven by states that had already met their 2009 goals prior to the beginning of the second MIPPA grant.
Figure 3: Number of LIS and MSP Applications by Quarter 70,000 61,329
60,000
53,166
50,047
50,000
46,780
40,000
30,000
10,000
36,033
37,252 27,317 14,832 12,485
34,295
31,389 24,077
20,000
57,774
18,658
24,952 21,828
29,997
19,885
24,039
23,732
16,148
0 Jun - Sep Oct - Dec Jan - Mar Apr - Jun Jul - Sep Oct - Dec Jan - Mar 2009 2009 2010 2010 2010 2010 2011 MSP Applications LIS Applications Total Applications Source: National Council on Aging, BenefitsCheckUp.org MIPPA Reporting System, (June 1, 2009 to March 31, 2011)
4
Figure 4: Total LIS and MSP Applications Submitted by MIPPA Grantees under the 2009 MIPPA Grant by State and Goal Completion Status*
1,665 NH
5,466 WA
Not MIPPA ND
2,752 MT 2,186 OR 3,748 ID Not MIPPA WY
1,402 NV
930 UT
1,567 SD
4,420 AZ
5,507 OK
3,692 MO
4,269 OH
2,725 IN
4,101 WV 8,279 KY
5,000 VA 7,239 NC
7,128 TN 1,971 AR
4,793 CT 5,000 NJ Not MIPPA DE 1,000 DC 6,378 MD
2,263 SC 7,644 MS
3,082 TX
2,587 RI 5,742 PA
839 IA
1,584 KS
9,184 NM
3,433 MA
20,558 NY 7,085 MI
30,847 IL
1,216 CO
5,623 ME
3,307 MN
7,669 WI
928 NE 6,730 CA
1,473 VT
9,016 AL
11,603 GA
2,250 LA
851 AK
9,797 FL 1,052 HI
2009 Goal Completed 2009 Goal in Progress Not MIPPA
Source: National Council on Aging, BenefitsCheckUp.org MIPPA Reporting System (June 1, 2009 to March 31, 2011) Note: * Delaware, North Dakota, and Wyoming did not apply for 2009 MIPPA grant.
5
Figure 5: Total LIS and MSP Applications Submitted by MIPPA Grantees under the 2010 MIPPA Grant by State and Status*
1,800 NH
2,672 WA 1,345 MT
Not MIPPA ND
1,061 OR 824 ID 121 WY
NV
361 UT
191 SD
1,180 MA
7,473 NY
4,002 RI
MI 1,784 PA
954 IA
14,768 IL
3,018 CO
KS
1,228 AZ
808 ME
4,031 WI
1,158 NE
3,494 CA
VT 1,430 MN
518 OK NM
502 MO
2,027 WV
465 VA
2,094 KY
1,961 NC
1,740 TN 544 AR
101 DC
394 DE
3,723 MD
1,092 SC Not MIPPA MS
2,650 TX
OH IN
1,289 CT
32 NJ
3,871 AL
3,914 GA
197 LA
135 AK
5,036 FL
HI
Working towards 2010 goals Working towards 2009 goals Not MIPPA
Source: National Council on Aging, BenefitsCheckUp.org MIPPA Reporting System (June 1, 2009 to March 31, 2011) Note: * Mississippi and North Dakota, did not apply for 2010 MIPPA grants.
6
HIGHLIGHTS OF MIPPA ACTIVITIES Each reporting period, MIPPA grantees provide valuable information about their outreach and enrollment activities in the open-ended portion of the quarterly report. According to the information provided by MIPPA grantees, this most recent reporting period was characterized by: Using Promotores to Connect with the Hispanic Community The emphasis of the second MIPPA grant on prevention and wellness, and access to affordable health care among low-income Medicare beneficiaries has encouraged many MIPPA grantees to seek partnerships with community-based health promotion programs. The MIPPA grantees of Texas and Wisconsin have developed partnerships with their Promotores program to support their MIPPA efforts The South Texas AAA and Bexar County AAA trained their Promotores to educate and refer for additional assistance eligible individuals identified in their door-to-door activities targeted to low-income Spanish speaking neighborhoods. Similarly, Los Abuelitos Hispanic Outreach Project is building partnerships for culturally competent outreach and assistance through Promotores among Spanish speakers in Southeastern Wisconsin. Trusted bilingual support such as the one provided by the Promotores is critical to connect eligible beneficiaries with the agencies that provide personalized enrollment assistance. Finding New Ways to Connect with Rural Populations One-fifth of Medicare beneficiaries live in rural areas.3 MIPPA places a strong emphasis on helping Medicare beneficiaries in these areas to become enrolled in LIS and MSP, and to receive personalized assistance with their Part D plan comparison and selection. Rural Medicare beneficiaries face a unique set of challenges in plan selection and access to services that makes the type of assistance provided under MIPPA even more essential to this population. One unique aspect of MIPPA is that it has promoted statewide discussions among AAAs and ADRCs and SHIPs on the methods and strategies employed to reach this population. In Missouri, the MIPPA grantee held two bi-monthly conference calls for all the grantees where the main topics addressed best practices and models for how to reach rural Medicare beneficiaries. MIPPA has also helped the aging network to identify underserved segments of the rural population. As part of their process of developing their second MIPPA grant, Iowa identified rural nursing home residents as an underserved population. To address to needs of this population, the MIPPA SHIIP grantee developed the Nursing Facility Pilot. In this pilot project, MIPPA supported staff and volunteers work with social workers or other nursing facility staff to gather Part D Drug Information Forms from residents and run comparisons. As part of the project, the MIPPA grantee is training the nursing home staff on how to review the comparisons with residents or family members, and request enrollments in new plans if necessary. Lastly, MIPPA has also fostered the emergence of new ideas and practices that aim to bring personalized assistance to rural beneficiaries. The Access to Healthcare Network, a local MIPPA partner in Nevada, is leveraging its experience using Skype to provide personalized assistance to uninsured individuals living in rural areas, to help low-income Medicare beneficiaries to enroll in LIS and MSP.
3
Kaiser Family Foundation, Chart: Percent of Medicare Beneficiaries Residing in Rural Counties, by State, 2010. Available online at: http://facts.kff.org/chart.aspx?cb=58&sctn=162&ch=1717
7
Table 1: LIS and MSP Application Submissions and Value of Benefits
(January 1, 2011 – March 31, 2011) LIS Applications
MSP Applications
Total Applications
Value of Benefits ($)
406
796
1,202
$2,877,488
28 248 279 919 220 39
31 332 121 1,003 181 365
59 580 400 1,922 401 404
$160,817 $1,514,812 $1,306,543 $5,255,458 $1,165,027 $730,778
107 0 2,017 1,487 21 175
27 146 2,024 475 367 174
134 146 4,041 1,962 388 349
$470,518 $261,632 $11,255,261 $6,695,998 $661,927 $974,004
7,273 396 290 48 1,223 303
3,034 242 150 41 983 185
10,307 638 440 89 2,206 488
$33,869,742 $1,965,086 $1,396,210 $256,564 $6,439,963 $1,503,326
Maine Maryland Massachusetts Michigan Minnesota a Mississippi
16 792 232 935 481 459
290 742 311 687 437 283
306 1,534 543 1,622 918 742
$520,673 $4,336,452 $1,417,742 $4,821,842 $2,612,159 $2,281,650
Missouri Montana Nebraska Nevada New Hampshire New Jersey
685 413 92 503 162 372
500 149 22 56 129 415
1,185 562 114 559 291 787
$3,527,367 $1,886,635 $402,644 $2,100,185 $851,141 $2,141,514
New Mexico a New York North Carolina Ohio Oklahoma Oregon
271 801 948 463 200 170
594 2,593 28 120 67 163
865 3,394 976 583 267 333
$2,019,392 $7,287,284 $3,836,093 $2,040,968 $905,507 $936,682
State Alabama
a
Alaska a Arizona Arkansas California Colorado Connecticut Delaware ac DC Florida Georgia Hawaii Idaho
b
Illinois Indiana Iowa Kansas Kentucky Louisiana a
8
LIS Applications
MSP Applications
Total Applications
Value of Benefits ($)
955 189 302 53
322 324 344 24
1,277 513 646 77
$4,327,064 $1,266,214 $1,749,708 $249,794
Tennessee Texas Utah a Vermont Virginia Washington
708 1,246 104 34 1,065 395
740 649 50 17 190 593
1,448 1,895 154 51 1,255 988
$3,997,303 $6,006,002 $494,737 $162,770 $4,559,199 $2,513,817
West Virginia e Wisconsin b Wyoming Quarter Total
474 925 73 29,997
339 1,839 38 23,732
State Pennsylvania Rhode Island South Carolina South Dakota
813 $2,429,835 2,764 $6,595,935 111 $351,840 53,729 $157,391,298 Source: National Council on Aging, BenefitsCheckUp.org MIPPA Reporting System, (January 1, 2011 to March 31, 2011) Notes: a These states have eliminated the asset test for their Medicare Saving Programs. b New MIPPA states. Enrollment efforts began on October 1, 2010. c In the District of Columbia, the income limit for the MSP program is 300% of the Federal Poverty Level. Due to this higher income limit for MSP, DC’s MIPPA partners are focusing their efforts on enrolling individuals into MSP rather than LIS. MIPPA grantees have chosen this strategy as individuals who are approved for MSP are automatically deemed eligible for LIS. DC’s value of benefits for MSP per individual is also higher than for all other states, because all MSP enrollments in DC are for the Qualified Medicare Beneficiary program. Since all MSP beneficiaries are automatically deemed eligible for LIS, if we count the value of LIS towards DC efforts, their total value of benefits would show an additional $584,000. d It is common practice (previously a requirement) in Illinois to complete an LIS application for individuals who are applying for the State Pharmaceutical Assistance Program. e This number includes SeniorCare (WI’s SPAP) Level 1 applications.
9
OVERVIEW: Figure 1: Summary of Applications Submitted by Year (June 1, 2009 – March 31, 2011) APPLICATION TYPE
2009
2010
2011
Total
TOTAL VALUE OF BENEFITS
LIS
46,221
116,384
29,997
192,602
$765,785,900
MSP TOTAL*
31,143
86,092
23,732
140,967
$209,729,054
77,364
202,476
53,729
333,569
$975,514,954
*Includes Wisconsin SeniorCare 1 SPAP enrollments
Since June 2009, MIPPA grantees have: Submitted 192,602applications for the Part D Low-Income Subsidy. Submitted 140,967 applications for the Medicare Savings Programs, many of which were full Medicaid applications. Completed 128 percent of their first MIPPA grant two-year goal in the first 15 months of the grant, and 28 percent of their second MIPPA grant two-year goal. Helped individuals apply for close to $1 billion in LIS and MSP benefits alone, contributing to greater access to health care and economic security and strengthening the economies in their communities. In 2010, the 116,384 LIS applications submitted by MIPPA grantees reduced the number of people missing out on LIS by 7.3 percent. In several states (Alaska, Illinois, Maryland, Montana, New Mexico), the gap has been closed by more than 20 percent.
GRANTEES’ PROGRESS Between January 1, 2011 and March 31, 2011, 29,997 LIS applications and 23,732 MSP applications were submitted on behalf of low-income seniors and younger adults with disabilities, providing them with nearly $157 million in benefits.1 The applications submitted during this quarter raise the total cumulative number of application to 333,569 and the total value of benefits to nearly $1 billion.
Figure 2: Cumulative Number of LIS and MSP Applications by Quarter Total: 333,569
340,000
23,732
320,000 300,000
Total: 279,840
280,000
24,039
260,000 240,000
Total: 221,506
220,000 200,000
Total: 185,473 21,828
180,000 160,000
Total: 138,693
140,000 120,000
24,077
100,000
37,252
Total: 77,364
0
16,148 19,885
24,952
279,840
Total: 27,317 12,485 14,832 Jun to Sep 2009
31,389
185,473 138,693
18,658
60,000 20,000
34,295
221,506
80,000 40,000
29,997
77,364
27,317 Oct to Dec 2009
Jan to Mar 2010
Apr to Jun 2010
Applications from Previous Quarters
Jul to Sep 2010
New LIS
Oct to Dec 2010
Jan to Mar 2011
New MSP
Source: National Council on Aging, BenefitsCheckUp.org MIPPA Reporting System, (June 1, 2009 to March 31, 2011)
1
The total value of benefits is obtained by multiplying the number of applications by the annual value of each benefit. According to the Social Security Administration, the annual value of the Low-Income Subsidy in 2011 is $4,000. The annual value of the Medicare Savings Programs is the weighted average value of QMB, SLMB and QI in 2011. Based on NCOA’s BenefitsCheckUp.org data, the weighted average value of these programs is $1,574.73. In the District of Columbia where there are no SLMB and QI programs, the estimated annual value of MSP is $1,792.
2
Several states reported significant increases in their number of LIS and MSP applications submitted during this quarter. In absolute terms, Florida, Illinois, and New York had the highest increase in applications, with over 4,000 applications submitted during the past quarter. As of March 31, 2011, Illinois and New York had submitted the highest total number of LIS and MSP applications since June 2009. Both states lead the nation in absolute number of applications primarily due to the size of their Medicare eligible population and also their ability to leverage the enrollment in their state pharmaceutical assistance programs. Two groups of states reported the highest percent growth in applications during this quarter. The first group is made up of the new MIPPA grantees of Delaware and Wyoming. These states showed the strongest performance. The second group of states is made up of the states that had a late start in MIPPA 2009 or that struggled to meet their goals at earlier stages of the MIPPA grant (Hawaii, Nevada, Michigan, Texas, and Virginia). These states reported increases above the national average of 19 percent. The efforts of this most recent quarter helped the District of Columbia, Kentucky, Louisiana, Missouri, New Jersey, and Virginia to achieve 100 percent of their 2009 MIPPA goal. These states will join the 34 states that completed their 2009 goal and are now working toward the completion of their 2010 MIPPA goals. Seasonality in MIPPA Data After seven quarters of reported data, the cumulative data provides a picture of trends and seasonality in MIPPA efforts. Figure 3 shows the number of LIS and MSP applications by quarter since June 2009. As expected, MIPPA enrollment efforts show a seasonal pattern that aligns with the annual enrollment period for Part D (October to December) and Medicare Advantage open enrollment period (January to March), which typically have the highest number of contacts between counselors and Medicare beneficiaries. MIPPA efforts have been consistent during these periods, yielding over 50,000 LIS and MSP applications. The data also shows that with one exception (January to March quarters in 2010 and 2011), MIPPA efforts have improved over time when compared to similar quarters in previous years. The data provides further evidence that supports two trends that were discussed in an earlier MIPPA report. 2 The first trend shows a decreasing gap between the number of LIS and MSP applications. This trend is the result of (1) the growing number of states that secured a data-sharing agreement with their state Medicaid office to process the LIS data that is sent by SSA; (2) an increasing number of local MIPPA partners who are for their first time completing and submitting MSP applications despite the relative challenges of these applications; and (3) the improved accuracy in counting and reporting the individuals who are helped with an MSP application, specially individuals for whom a full Medicaid application was submitted. These trends will continue in future quarters as a result of a new reporting policy established by AoA, CMS and NCBOE that encourages grantees to provide follow-up and troubleshooting on MSP applications that are denied by the state Medicaid agency. Another pattern observed in the data relates to the effects of the second MIPPA grant. In an earlier report, we noticed that “[ t]here is marked slowdown in the states that have achieved 100 percent of their 2009 goal [prior to June 30, 2010]. On average, states that achieved their goals [prior to June 30, 2010] reported a 17 percent increase in submissions. In contrast, the remaining states reported a 34 2
See page 3 of NCBOE, MIPPA Grantee Quarterly Report (June 2010 to September 2010) released on December 10, 2010.
3
percent increase in submissions.” However, Figure 3 shows that the second MIPPA grant provided a new impetus to MIPPA efforts that reversed the observed trend. The October to December 2010 quarter showed the largest growth in applications seen since the beginning of MIPPA in 2009. This growth was driven by states that had already met their 2009 goals prior to the beginning of the second MIPPA grant.
Figure 3: Number of LIS and MSP Applications by Quarter 70,000 61,329
60,000
53,166
50,047
50,000
46,780
40,000
30,000
10,000
36,033
37,252 27,317 14,832 12,485
34,295
31,389 24,077
20,000
57,774
18,658
24,952 21,828
29,997
19,885
24,039
23,732
16,148
0 Jun - Sep Oct - Dec Jan - Mar Apr - Jun Jul - Sep Oct - Dec Jan - Mar 2009 2009 2010 2010 2010 2010 2011 MSP Applications LIS Applications Total Applications Source: National Council on Aging, BenefitsCheckUp.org MIPPA Reporting System, (June 1, 2009 to March 31, 2011)
4
Figure 4: Total LIS and MSP Applications Submitted by MIPPA Grantees under the 2009 MIPPA Grant by State and Goal Completion Status*
1,665 NH
5,466 WA
Not MIPPA ND
2,752 MT 2,186 OR 3,748 ID Not MIPPA WY
1,402 NV
930 UT
1,567 SD
4,420 AZ
5,507 OK
3,692 MO
4,269 OH
2,725 IN
4,101 WV 8,279 KY
5,000 VA 7,239 NC
7,128 TN 1,971 AR
4,793 CT 5,000 NJ Not MIPPA DE 1,000 DC 6,378 MD
2,263 SC 7,644 MS
3,082 TX
2,587 RI 5,742 PA
839 IA
1,584 KS
9,184 NM
3,433 MA
20,558 NY 7,085 MI
30,847 IL
1,216 CO
5,623 ME
3,307 MN
7,669 WI
928 NE 6,730 CA
1,473 VT
9,016 AL
11,603 GA
2,250 LA
851 AK
9,797 FL 1,052 HI
2009 Goal Completed 2009 Goal in Progress Not MIPPA
Source: National Council on Aging, BenefitsCheckUp.org MIPPA Reporting System (June 1, 2009 to March 31, 2011) Note: * Delaware, North Dakota, and Wyoming did not apply for 2009 MIPPA grant.
5
Figure 5: Total LIS and MSP Applications Submitted by MIPPA Grantees under the 2010 MIPPA Grant by State and Status*
1,800 NH
2,672 WA 1,345 MT
Not MIPPA ND
1,061 OR 824 ID 121 WY
NV
361 UT
191 SD
1,180 MA
7,473 NY
4,002 RI
MI 1,784 PA
954 IA
14,768 IL
3,018 CO
KS
1,228 AZ
808 ME
4,031 WI
1,158 NE
3,494 CA
VT 1,430 MN
518 OK NM
502 MO
2,027 WV
465 VA
2,094 KY
1,961 NC
1,740 TN 544 AR
101 DC
394 DE
3,723 MD
1,092 SC Not MIPPA MS
2,650 TX
OH IN
1,289 CT
32 NJ
3,871 AL
3,914 GA
197 LA
135 AK
5,036 FL
HI
Working towards 2010 goals Working towards 2009 goals Not MIPPA
Source: National Council on Aging, BenefitsCheckUp.org MIPPA Reporting System (June 1, 2009 to March 31, 2011) Note: * Mississippi and North Dakota, did not apply for 2010 MIPPA grants.
6
HIGHLIGHTS OF MIPPA ACTIVITIES Each reporting period, MIPPA grantees provide valuable information about their outreach and enrollment activities in the open-ended portion of the quarterly report. According to the information provided by MIPPA grantees, this most recent reporting period was characterized by: Using Promotores to Connect with the Hispanic Community The emphasis of the second MIPPA grant on prevention and wellness, and access to affordable health care among low-income Medicare beneficiaries has encouraged many MIPPA grantees to seek partnerships with community-based health promotion programs. The MIPPA grantees of Texas and Wisconsin have developed partnerships with their Promotores program to support their MIPPA efforts The South Texas AAA and Bexar County AAA trained their Promotores to educate and refer for additional assistance eligible individuals identified in their door-to-door activities targeted to low-income Spanish speaking neighborhoods. Similarly, Los Abuelitos Hispanic Outreach Project is building partnerships for culturally competent outreach and assistance through Promotores among Spanish speakers in Southeastern Wisconsin. Trusted bilingual support such as the one provided by the Promotores is critical to connect eligible beneficiaries with the agencies that provide personalized enrollment assistance. Finding New Ways to Connect with Rural Populations One-fifth of Medicare beneficiaries live in rural areas.3 MIPPA places a strong emphasis on helping Medicare beneficiaries in these areas to become enrolled in LIS and MSP, and to receive personalized assistance with their Part D plan comparison and selection. Rural Medicare beneficiaries face a unique set of challenges in plan selection and access to services that makes the type of assistance provided under MIPPA even more essential to this population. One unique aspect of MIPPA is that it has promoted statewide discussions among AAAs and ADRCs and SHIPs on the methods and strategies employed to reach this population. In Missouri, the MIPPA grantee held two bi-monthly conference calls for all the grantees where the main topics addressed best practices and models for how to reach rural Medicare beneficiaries. MIPPA has also helped the aging network to identify underserved segments of the rural population. As part of their process of developing their second MIPPA grant, Iowa identified rural nursing home residents as an underserved population. To address to needs of this population, the MIPPA SHIIP grantee developed the Nursing Facility Pilot. In this pilot project, MIPPA supported staff and volunteers work with social workers or other nursing facility staff to gather Part D Drug Information Forms from residents and run comparisons. As part of the project, the MIPPA grantee is training the nursing home staff on how to review the comparisons with residents or family members, and request enrollments in new plans if necessary. Lastly, MIPPA has also fostered the emergence of new ideas and practices that aim to bring personalized assistance to rural beneficiaries. The Access to Healthcare Network, a local MIPPA partner in Nevada, is leveraging its experience using Skype to provide personalized assistance to uninsured individuals living in rural areas, to help low-income Medicare beneficiaries to enroll in LIS and MSP.
3
Kaiser Family Foundation, Chart: Percent of Medicare Beneficiaries Residing in Rural Counties, by State, 2010. Available online at: http://facts.kff.org/chart.aspx?cb=58&sctn=162&ch=1717
7
Table 1: LIS and MSP Application Submissions and Value of Benefits
(January 1, 2011 – March 31, 2011) LIS Applications
MSP Applications
Total Applications
Value of Benefits ($)
406
796
1,202
$2,877,488
28 248 279 919 220 39
31 332 121 1,003 181 365
59 580 400 1,922 401 404
$160,817 $1,514,812 $1,306,543 $5,255,458 $1,165,027 $730,778
107 0 2,017 1,487 21 175
27 146 2,024 475 367 174
134 146 4,041 1,962 388 349
$470,518 $261,632 $11,255,261 $6,695,998 $661,927 $974,004
7,273 396 290 48 1,223 303
3,034 242 150 41 983 185
10,307 638 440 89 2,206 488
$33,869,742 $1,965,086 $1,396,210 $256,564 $6,439,963 $1,503,326
Maine Maryland Massachusetts Michigan Minnesota a Mississippi
16 792 232 935 481 459
290 742 311 687 437 283
306 1,534 543 1,622 918 742
$520,673 $4,336,452 $1,417,742 $4,821,842 $2,612,159 $2,281,650
Missouri Montana Nebraska Nevada New Hampshire New Jersey
685 413 92 503 162 372
500 149 22 56 129 415
1,185 562 114 559 291 787
$3,527,367 $1,886,635 $402,644 $2,100,185 $851,141 $2,141,514
New Mexico a New York North Carolina Ohio Oklahoma Oregon
271 801 948 463 200 170
594 2,593 28 120 67 163
865 3,394 976 583 267 333
$2,019,392 $7,287,284 $3,836,093 $2,040,968 $905,507 $936,682
State Alabama
a
Alaska a Arizona Arkansas California Colorado Connecticut Delaware ac DC Florida Georgia Hawaii Idaho
b
Illinois Indiana Iowa Kansas Kentucky Louisiana a
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LIS Applications
MSP Applications
Total Applications
Value of Benefits ($)
955 189 302 53
322 324 344 24
1,277 513 646 77
$4,327,064 $1,266,214 $1,749,708 $249,794
Tennessee Texas Utah a Vermont Virginia Washington
708 1,246 104 34 1,065 395
740 649 50 17 190 593
1,448 1,895 154 51 1,255 988
$3,997,303 $6,006,002 $494,737 $162,770 $4,559,199 $2,513,817
West Virginia e Wisconsin b Wyoming Quarter Total
474 925 73 29,997
339 1,839 38 23,732
State Pennsylvania Rhode Island South Carolina South Dakota
813 $2,429,835 2,764 $6,595,935 111 $351,840 53,729 $157,391,298 Source: National Council on Aging, BenefitsCheckUp.org MIPPA Reporting System, (January 1, 2011 to March 31, 2011) Notes: a These states have eliminated the asset test for their Medicare Saving Programs. b New MIPPA states. Enrollment efforts began on October 1, 2010. c In the District of Columbia, the income limit for the MSP program is 300% of the Federal Poverty Level. Due to this higher income limit for MSP, DC’s MIPPA partners are focusing their efforts on enrolling individuals into MSP rather than LIS. MIPPA grantees have chosen this strategy as individuals who are approved for MSP are automatically deemed eligible for LIS. DC’s value of benefits for MSP per individual is also higher than for all other states, because all MSP enrollments in DC are for the Qualified Medicare Beneficiary program. Since all MSP beneficiaries are automatically deemed eligible for LIS, if we count the value of LIS towards DC efforts, their total value of benefits would show an additional $584,000. d It is common practice (previously a requirement) in Illinois to complete an LIS application for individuals who are applying for the State Pharmaceutical Assistance Program. e This number includes SeniorCare (WI’s SPAP) Level 1 applications.
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