Medicare Subsidy Programs: Are Current Outreach and Enrollment Efforts Effective in Black Communities?

Background and Purpose: The Medicare Saving Program (MSP) and Low-Income Subsidy (LIS) program provide assistance with Medicare cost-sharing obligations and prescription drug expenses. These programs can substantially reduce cost burden for low-income beneficiaries and remove financial barriers to receiving health care and maintaining medication adherence. Despite the benefits associated with the MSP and LIS, the programs remain underutilized particularly within low-income, Black communities. This study examined whether attending a State Health Insurance Assistance Program (SHIP) outreach event within low-income, predominantly Black communities 1) increases MSP and LIS program familiarity and knowledge, and 2) impacts MSP and LIS enrollment.

Methods:  In its commitment to preserve the independence and promote the health of vulnerable older adults residing within the City of Buffalo, Erie County Department of Senior Services SHIP partnered the University at Buffalo School of Social Work and The National Witness Project, Inc. over a four-month period. During this time, the partnership planned, developed, and implemented five MSP and LIS outreach and enrollment events targeting the older Black community. Each event consisted of an informational presentation on the MSP and LIS benefits. Following the presentation, attendees were offered assistance in applying for these programs. Baseline participant data were collected by the presenter before the presentation and included demographic information, familiarity with the MSP and LIS programs, and knowledge of Medicare and related subsidies. Immediately after the presentation, a post-test was administered that assessed changes in MSP and LIS familiarity and knowledge along with questions pertaining to potential enrollment.

Results:  Multivariate regression results demonstrate that participating in a SHIP outreach event can increase MSP and LIS familiarity within predominantly lower-income, Black communities. Though the measure pertaining overall knowledge of the Medicare program and related subsidies was not statistically significant, findings indicate that there was an increase in knowledge after attending the presentation. Further, nearly one-half of those responding to the questions pertaining the application status indicated that they planned to apply for the LIS or MSP. 

Conclusions and Implications:  These findings are critical, particularly considering that racial and ethnic differences in LIS awareness exist. Considering efforts by the Department of Health and Human Services to reduce disparities in health and health care service use, it is imperative that outreach efforts target minority groups. The fact that the MSP and LIS can substantially lower health care costs and increase access to health care services among vulnerable populations underscores the importance of implementing targeted approaches for reaching minority groups.  Moreover, findings illustrate the need to advocate that current funding allocations for SHIP be maintained and adjustment increases to compensate for the growing aging population be provided in order to address the needs of at-risk groups and insure adequate support and assistance be provided.