First, about 40 percent of seniors read at or below the fifth-grade  level, but the reading levels of the documents ranged from seventh grade  to postcollege. Second, on average, the six documents we reviewed did not comply with  about half of the 60 commonly recognized guidelines for good  communications. For example, although the documents included concise  and descriptive headings, they used too much technical jargon and often  did not define difficult terms such as formulary. The 11 beneficiaries and   5 advisers we tested reported frustration with the documents’ lack of  clarity as they encountered difficulties in understanding and attempting to  complete 18 specified tasks. Help Line Responses Frequently Complete and Accurate, but Varied By Question

Of the 500 calls we placed to CMS’s 1-800-MEDICARE help line regarding  the Part D benefit, CSRs answered about 67 percent of the calls accurately  and completely. Of the remainder, 18 percent of the calls received  inaccurate responses, 8 percent of the responses were inappropriate given  the question asked, and about 3 percent received incomplete responses. In  addition, about 5 percent of our calls were not answered, primarily  because of disconnections. The accuracy and completeness of CSR responses varied significantly  across our five questions. 1.) For example, while CSRs provided  accurate and complete responses to calls about beneficiaries’ eligibility for  financial assistance 90 percent of the time, the accuracy rate for calls  concerning the drug plan that would cost the least for a beneficiary with  specified prescription drug needs was 41 percent. CSRs inappropriately  responded 35 percent of the time that this question could not be answered  without personal identifying information—such as the beneficiary’s  Medicare number or date of birth—even though the CSRs could have  answered our question using CMS’s Web-based prescription drug plan  finder tool. The time GAO callers waited to speak with CSRs  also varied, ranging from no wait time to over 55 minutes. For 75 percent  of the calls—374 of the 500—the wait was less than 5 minutes. Part D Benefit Portion of Medicare Web Site Can Be Challenging to Use

We found that the Part D benefit portion of the Medicare Web site can be  difficult to use. In our evaluation of overall usability—the ease of finding  needed information and performing various tasks—we found usability  scores of 47 percent for seniors and 53 percent for younger adults, out of a  possible 100 percent. While there is no widely accepted benchmark for  usability, these scores indicate difficulties in using the site. For example, key functions of the prescription  drug plan finder tool, such as the “continue” and “choose a drug plan”  buttons, were often not visible on the page without scrolling down. CMS faced a tremendous challenge in responding to  this need and, within short time frames, developed a range of outreach and  educational materials to inform beneficiaries and their advisers about the  Part D benefit. Although the initial  enrollment period for the Part D benefit will end on May 15, 2006, CMS  will continue to play a pivotal role in providing beneficiaries with  information about the drug benefit in the future.
Why GAO Did This Study

Today's hearing focuses on Medicare Part D, the program's new outpatient prescription drug benefit. On January 1, 2006, Medicare began providing this benefit, and beneficiaries have until May 15, 2006, to enroll without the risk of penalties. The Centers for Medicare & Medicaid Services (CMS), which administers the Part D benefit, has undertaken outreach and education efforts to inform beneficiaries and their advisers. GAO was asked to discuss how CMS can better ensure that Medicare beneficiaries are informed about the Part D benefit. This testimony is based on Medicare: CMS Communications to Beneficiaries on the Prescription Drug Benefit Could Be Improved, GAO-06-654 (May 3, 2006).

What GAO Found

Information given in the six sample documents that GAO reviewed describing the Part D benefit was largely complete and accurate, although this information lacked clarity. First, about 40 percent of seniors read at or below the fifth-grade level, but the reading levels of these documents ranged from seventh grade to postcollege. Second, on average, the six documents we reviewed did not comply with about half of 60 common guidelines for good communication. For example, the documents used too much technical jargon and often did not define difficult terms. Moreover, 16 beneficiaries and advisers that GAO tested reported frustration with the documents' lack of clarity and had difficulty completing the tasks assigned to them. Customer service representatives (CSRs) answered about two-thirds of the 500 calls GAO placed to CMS's 1-800-MEDICARE help line accurately and completely. Of the remainder, 18 percent of the calls received inaccurate responses, 8 percent of the responses were inappropriate given the question asked, and about 3 percent received incomplete responses. In addition, about 5 percent of GAO's calls were not answered, primarily because of disconnections. The accuracy and completeness of CSRs' responses varied significantly across the five questions. For example, while CSRs provided accurate and complete responses to calls about beneficiaries' eligibility for financial assistance 90 percent of the time, the accuracy rate for calls concerning the drug plan that would cost the least for a beneficiary with specified prescription drug needs was 41 percent. For this question, the CSRs responded inappropriately for 35 percent of the calls by explaining that they could not identify the least costly plan without the beneficiary's personal information--even though CSRs had the information needed to answer the question. The time GAO callers waited to speak with CSRs also varied, ranging from no wait time to over 55 minutes. For 75 percent of the calls--374 of the 500--the wait was less than 5 minutes. The Part D benefit portion of the Medicare Web site can be difficult to use. GAO's test of the site's overall usability--the ease of finding needed information and performing various tasks--resulted in scores of 47 percent for seniors and 53 percent for younger adults, out of a possible 100 percent. While there is no widely accepted benchmark for usability, these scores indicate that using the site can be difficult. For example, the prescription drug plan finder was complicated to use and some of its key functions, such as "continue" and "choose a drug plan," were often not visible on the page without scrolling down.