Information Needs and Preferences of the Medicare Population with Vision Loss
The Health Care Financing Administration (HCFA) has identified a diverse set of beneficiary subgroups that may have special information needs about Medicare, or may require innovative communication approaches. This article synthesizes key findings from research (1997 inventory research, 1997 focus groups; and the 1998 Medicare Current Beneficiary Survey [MCBS]) conducted with those elderly beneficiaries with vision loss (both those with partial vision loss and those who are blind) who are age 65 or over and not institutionalized.
It is important to keep in mind that vision loss takes varying forms (e.g., general blurting, loss of peripheral vision, loss of ability to distinguish colors) and comes in varying degrees. Therefore, the communication needs and preferences may vary (for example, printed communications appropriate for beneficiaries with partial vision loss would not meet the needs of the small subset of this population who are blind).
PROFILE OF MEDICARE BENEFICIARIES WITH VISION LOSS
According to the 1996-1997 MCBS, almost 40 percent of non-institutionalized Medicare beneficiaries report having difficulty seeing, even with corrective lenses. Only a small percentage of these individuals--less than 1 percent of the Medicare population--are completely blind, but vision loss can represent a significant barrier to communicating with the Medicare population.
Compared with elderly Medicare beneficiaries in general, beneficiaries who have partial or complete vision loss:
* Tend to be older.
* Are somewhat more likely to live alone or with children or other relatives or non-relatives, and less likely to be living with a spouse.
* Have lower incomes and are less educated.
* Are more likely to be Medicaid recipients.
* Are more likely to report being in fair or poor health, and to have problems with hearing and activities of daily living.
KEY INFORMATION NEEDS AND KNOWLEDGE
For the most part, beneficiaries with vision loss have information needs that resemble those of the general elderly Medicare population. They ask the same questions and demonstrate the same gaps in understanding about the Medicare program. However, they also have unique needs. Key findings about the information needs and Medicare-related knowledge levels of blind and low vision beneficiaries, as compared with the general beneficiary population, include:
* They are somewhat more likely to need basic information about Medicare, as they are not able to access information as readily as full-sighted beneficiaries.
* They are also somewhat more likely to seek information, but are less likely to find it when they do.
* They need information on the prevention, diagnosis, and treatment of vision loss; coverage of vision assistive devices; and coping strategies.
* For those who have lost their vision gradually and are not accustomed to low vision, advice on alternative ways of dealing with daily life and on coping strategies are helpful to them and their families.
* What services are covered by Medicare? Are glasses, closed circuit televisions, and other necessary low vision aids covered?
* Who pays for low vision services?
* What is the role of managed care in Medicare?
* How does managed care fit into the health care system?
PREFERRED INFORMATION SOURCES
Beneficiaries with vision loss are generally similar to other Medicare beneficiaries in the sources they rely on to obtain information about the Medicare program. The preferred source depends on the topic.
* For information about the Medicare program and out-of-pocket costs, the majority of those reporting rely on Medicare sources (e.g., publications, carriers, toll-free line). …