Initial Results and Evaluation Design for the SSA Medicare Part B Buy-in Demonstration
June 2000
Social Security Administration
Lewin contact: Lisa Alecxih
SSA was mandated to conduct a demonstration to test outreach and application methods for enrollment in Medicare Part B Buy-in programs in which state Medicaid programs pay for Medicare Part B premiums and possibly Medicare copayments and deductibles for low income beneficiaries. The demonstration included mailing letters to all potentially eligible individuals in eleven sites in six states informing them of the benefits and asking them to contact SSA. Of the nearly 240,000 letters mailed, approximately six percent responded and 61 percent appeared to meet the required income and asset limits. Depending upon the site, one of the three models for application referral and intake were employed: 1) Screening Only, where potential eligibles were made an appointment with the local Medicaid or welfare office; 2) Co-location, where a state Medicaid or welfare worker was onsite at the SSA office; and 3) Application, where SSA staff filled out state application forms and forwarded them to the state for processing.
This report describes the demonstration, documents its implementation, presents descriptive analyses of individuals targeted for the program, and discusses our plans for assessing the effectiveness of the models. The key process lessons include the need for clear communication among all parties involved in the demonstration; a well-defined liaison role to resolve implementation problems efficiently; accountability on the part of the central office and the field offices participating in the demonstration; adequate training; local flexibility in implementation strategy; and commitment from major players.