摘要：Many Medicare recipients do not understand their health care rights. Lumetra, formerly California's Medicare quality improvement organization, developed a multifaceted outreach program to increase beneficiary awareness of its services and of the right to file quality-of-care complaints and discharge appeals. Layered outreach activities to Medicare members and their caregivers in 2 targeted counties consisted of paid media, direct mailings, community outreach, and online marketing. Calls to Lumetra's helpline and visits to its Web site—measures of beneficiary awareness of case review services—increased by 106% and 1214%, respectively, in the targeted counties during the 4-month outreach period. Only small increases occurred in nontargeted counties. Increases in quality-of-care complaints and discharge appeal rates were detected during a longer follow-up period. THE MEDICARE POPULATION will grow considerably as baby boomers (persons born between 1946 and 1965) begin entering the program, increasing the demand for geriatric health care services and for clear information about Medicare benefits and rights. The Centers for Medicare and Medicaid Services contracts with quality improvement organizations (QIOs) to protect and improve care for Medicare beneficiaries. 1 This includes responding to quality-of-care complaints and discharge appeals (hereafter, complaints and appeals). 2 Studies have found that many Medicare members have a limited understanding of their rights and of QIO services, and complaint and appeal rates are low. 3 – 5 QIOs have historically conducted outreach to improve beneficiary awareness, but the effectiveness of these efforts is unknown. 4 Lumetra, formerly California's QIO, received funding from the Centers for Medicare and Medicaid Services to develop, implement, and evaluate outreach activities to increase beneficiary awareness of the QIO case review program. We assessed the effectiveness of this outreach program. KEY FINDINGS ▪ Multifaceted outreach activities directed to Medicare members and their caregivers dramatically increased quality improvement organization helpline calls and Web site visits during the 4-month outreach period. ▪ Quality-of-care complaint and discharge appeal rates increased during a longer (7-month) follow-up period. ▪ Helpline callers were most likely to have learned about Lumetra through direct mail interventions (postcard or Medicare rights booklet). • Helpline caller responses indicated that calls were also prompted by radio and newspaper ads.
