Medicare Advantage Community Education Project

Helping Communities Navigate Medicare Coverage Choices

Texas rural hospitals face a barrage of challenges. Among them, Medicare Advantage.

Seniors may perceive incentives and lower costs associated with the program as benefits, only to discover Medicare Advantage plans often lead to delays in care, excessive denials, and frustration. These plans also create onerous administrative burdens for health care providers, destabilizing finances for rural hospitals and their ability to provide care in their communities.

Groundswell Health, in coordination with Texas A&M University, has launched a multi-channel community engagement campaign for hospital leaders to equip multiple audiences with the resources needed to navigate the complex choices around Medicare.

Campaign materials will:

• Ensure Texas Medicare enrollees have the information they need to make an informed decision about their coverage.
• Engage community leaders, employers, and others to better understand the impact increasing Medicare Advantage enrollment has on rural hospitals’ ability to provide care.
• Support hospital leaders in effectively communicating the financial challenges surrounding these plans and potential solutions with decision-makers.

Program Outline

Three Audiences. One Message.

Participating Texas hospitals get access to organized messaging to help individuals and families in their communities who might be navigating the complex territory of Medicare. These campaigns direct consumers to helpful information with clarity around what Medicare programs are and aren’t. By participating, hospitals leaders get access to content and promotional materials to:

1. Place on internal websites
2. Place on social media
3. Place with local newspapers
4. Engage elected leaders and local officials
5. Engage and brief internal stakeholders such as medical staff and directors.

Engaging community members, internal stakeholders, and lawmakers with clear, accurate, and digestible messaging on the differences between Traditional Medicare and Medicare Advantage and the disadvantages of Medicare Advantage plans for all three audiences is the goal of this campaign.

Campaign Objectives

• Increase community awareness of the importance of making a well-informed decision about Medicare coverage and the potential risks of selecting a Medicare Advantage plan.
• Inform policy leaders and regulators of the impact of Medicare Advantage on rural hospitals and needed remedies.
• Restore trust and confidence in the local community’s healthcare leaders and officials.
• Rally support and awareness among local community stakeholders for their local healthcare organizations.

Sample Campaign Messages

Effective messaging for an audience looking for solutions do more than inform. They also educate. They shed light on otherwise opaque incentives and clarify faults in what commercial health plans highlight as features. In addition, effective messages highlight what decision-makers should be looking for in their Medicare plan.

• Everyone deserves choices in health care. Making an informed choice about your health insurance coverage depends on having all the information.
• We encourage our Medicare-eligible residents to ask questions before selecting a Medicare Advantage plan.
• Ask if your doctor is an in-network provider.
• Health care needs are hard to predict. Only traditional Medicare preserves the freedom and flexibility to see specialists.
• Ask about limits on coverage for hospital stays or rehabilitation after a hospitalization.
• Medicare open enrollment begins in October. Start planning now by gathering information and talking to your health care team.
• Understand the challenges of switching back to traditional Medicare after being enrolled in a Medicare Advantage plan.
• From October 15 to December 7, you can switch back to traditional Medicare or switch plans.

Campaign Elements and Tools Include: 

• Social media content
• Traditional media content
• Radio spots
• Web articles and blog content
• Op-Eds for local media
• Physical signage
• PowerPoint templates
• Issue briefs and explainer documents for lawmakers
• Letters to lawmakers

Program Timeline

Starting in June 2024, participating hospital leaders will work with coordinators and Groundswell Health to launch messaging into communities across the state. Armed with a set of messaging tools for placement in a variety of channels, organizations can begin distribution and promotion in their respective communities to highlight the disadvantages of Medicare Advantage.

Messaging Timeline

Round 1: June 1 – July 31

• Campaign assets available June 1

• Campaign assets available July 15

• Campaign assets available September 15

• Campaign assets available November 15

• Outreach and Engagement Overview: April 15
  • Groundswell Health in partnership with Texas A&M University provides an overview of outreach and engagement in your communities.
• Campaign Kickoff and Messaging Overview: May 15 – June 1
  • Groundswell Health will introduce campaign timelines and messaging cadence details.
• Campaign Update: July 15
• Campaign Update: September 15
• Campaign Update: November 15

Campaign Downloads

More Information on Medicare Advantage

Medicare Advantage Background

In 2023, 30.8 million seniors enrolled in a Medicare Advantage plan, accounting for about half of the Medicare eligible population. Over the last 20 years, financial incentives drove commercial health insurers to develop a market for these private Medicare plans. Medicare Advantage plans account for about $454 billion of total federal Medicare spending, approximately 54% of total federal Medicare spending.

Despite Medicare Advantage plans being criticized for burdensome prior authorization requirements, unwarranted denials, reimbursement delays, and network inadequacy, enrollment continues to grow. More than 50% of eligible beneficiaries were expected to enroll in a Medicare Advantage plan in 2023.

The landscape for traditional Medicare alone is confusing. Adding to that a fear of the unknown and the complex wilderness of healthcare, today’s seniors are at-risk for choosing plans that sound appealing but might have no way of benefiting them based on a number of conditions. According to Kaiser Family Foundation, the average Medicare beneficiary has 43 Medicare Advantage plans to consider.