Early Information on Distributed on Medicare Prescription Drug Discount Cards Not Helpful, HHS OIG Memo Says
The early information that Medicare beneficiaries received about the new Medicare prescription drug discount card program was "confusing or inadequate" and did little to help them make an informed choice, according to an HHS Office of Inspector General memo, the AP/Las Vegas Sun reports. The internal memo, dated Sept. 29, was based on an informal survey of 59 beneficiaries, many of whom were relatives of HHS employees. The survey was conducted in May and June, soon after the federal government and insurers approved by the government to offer discount cards were allowed to begin mailing information to beneficiaries.
Assistant Inspector General George Grob wrote, "Contrary to expectations, during the initial startup of the drug card program, we found that the 59 selected beneficiaries received little or no mail about the drug card program from sponsors to assist them in making a choice among drug cards." He added, "We found that these beneficiaries received very little mail from drug card sponsors that would enable them to make an informed choice among cards," and the information they did receive "was not easily understood."
Grob noted that many of the beneficiaries surveyed also had received mail from other prescription drug discount programs that offered "competing services ... which might cause beneficiaries to question whether to enroll in the drug card program at all."
In a follow-up memo, Grob said that OIG is not releasing the findings of the survey to the public because the initial review was designed as a "very quick and early assessment," and it should not be used to judge the launch of the drug card program. OIG officials said the real value of the survey is "to dispel early expectations that seniors were going to be inundated with material" about the drug cards and also to highlight lessons learned from the launch of the program that could be used when the full Medicare prescription drug benefit begins in 2006.
OIG is conducting a more formal investigation to determine whether there were widespread problems with the drug card program.
HHS spokesperson William Pierce said, "If I had presented this in college statistics class, I would have flunked. The results, whatever they say, are invalid results because this was a nonrandom, tiny sample."
In a response to the memo last week, CMS Administrator Mark McClellan also said the survey sample was too small, adding, "What concerns me even more is what I have learned about the nature of who the IG's office recruited to be in the sample -- family and friends of OIG office staff. This is a nonrepresentative sample and not a valid way to conduct a reliable and statistically valid analysis."
HHS officials also said the initial survey did not take into account an advertising campaign and direct mail effort this summer. They noted that the campaign, which also included the establishment of a toll-free telephone number to give beneficiaries more information, resulted in a "10,000-a-day enrollment spurt for the cards," the AP/Sun reports.
HHS officials also raised concerns about the timing of the memo, noting that it was released the day before the first debate between President Bush and Democratic presidential nominee Sen. John Kerry (Mass.), even though the survey was conducted in May and June, and HHS officials were briefed on the results verbally in July. Pierce said officials will wait for the results of the formal review (Solomon, AP/Las Vegas Sun, 10/14).