Overview of the MIPPA Program
The Medicare Improvement for Patients and Providers Act (MIPPA) program supports states and tribes through grants to provide outreach and assistance to eligible Medicare beneficiaries to apply for benefit programs that help to lower the costs of their Medicare premiums and deductibles. MIPPA state grants provide targeted funding to State Health Insurance Assistance Programs (SHIP), Area Agencies on Aging (AAA), and Aging and Disability Resource Centers (ADRC). Grantees help educate beneficiaries about the Low-Income Subsidy (LIS) program for Medicare Part D, Medicare Savings Programs (MSPs), and Medicare Preventive Services. This initiative also includes special efforts to target rural areas and Native American elders.
The Role of the National Center for Benefits Outreach and Enrollment
In recognition of the underutilization of federal and state benefit programs, Congress amended the Older Americans Act (OAA) in 2006 with language directing the Administration on Aging (now ACL) to provide technical assistance to states, State Health Insurance Assistance Programs (SHIPs), AAAs, ADRCs and community service organizations who provide outreach and benefits enrollment assistance for federal and state programs.
Further, in reauthorizing the OAA, Congress directed ACL to work with an experienced entity to establish a National Center on Benefits Outreach and Enrollment (NCBOE) to:
Maintain and update web-based decision support and enrollment tools and integrated, person-centered systems designed to inform older individuals and people with disabilities about the full range of benefits for which the individuals may be eligible under federal and state programs;
Utilize cost-effective strategies to find older individuals and people with disabilities with greatest economic need and enroll the individuals in the programs for which they are qualified;
Create and support efforts for ADRCs, and other public and private state and community-based organizations, including faith-based organizations and coalitions, disability organizations and coalitions to serve as benefits enrollment centers for the programs;
Develop and maintain an information clearinghouse on best practices and cost-effective methods for finding and enrolling older individuals and people with disabilities with greatest economic need in the programs for which the individuals are eligible; and
Provide, in collaboration with related federal agency partners administering the federal programs, training and technical assistance on effective outreach, screening, enrollment, and follow-up strategies.
The NCBOE grantee is expected to coordinate efforts to inform older Americans and beneficiaries with disabilities about the benefits they qualify for under federal and state programs through outreach, state and local partnerships, and web based screening tools. The program’s emphasis is on providing information on programs to help Medicare beneficiaries pay for their Medicare coverage, specifically the Low-Income Subsidy (LIS) and Medicare Savings Programs (MSP); however, it is important that they also take the whole person into account and offer a range of information including topics such as integrated care. The NCBOE will also serve as a technical assistance resource center for state grantees who receive funding established under the Medicare Improvements for Patients and Providers Act (MIPPA).
NCBOE Priority Objectives and Activities:
The overarching goal of the NCBOE is to increase awareness and utilization of benefits and services to support low-income Medicare beneficiaries. The objectives and activities listed below should each include the appropriate outreach and education campaigns as well as plans to create and/or strengthen partnerships to assist beneficiaries. Additionally, the applicant should provide plans to monitor the impact of their technical assistance to ensure they have achieved their goals.
Provide Public Web-Based Decision Support and Enrollment Tools
The NCBOE grantee is expected to develop, maintain, and update web-based decision support and enrollment tools and integrated, person-centered systems designed to inform older adults and individuals with disabilities about the full range of benefits for which the individuals may be eligible under federal and state programs. As part of this work, the grantee should provide education to help aging and disability network counselors understand beneficiaries’ options related to integrated care. By integrated care, ACL means all healthcare options for which the beneficiary may be eligible to address their health and social needs that support beneficiaries’ independence at home and in the community.
Applicants to this funding opportunity should provide plans to create and/or provide easy to use publicly available web-based decision support tools that will:
Provide eligibility screening and application assistance for federal and state funded programs, including integrated care programs;
Provide information about the full range of benefits available to individuals, including functionality that personalizes searches based on current benefit status that would indicate eligibility for other programs/benefits;
Aggregate geographic specific eligibility criteria by benefit;
Provide a way for consumers to receive additional information and/or personalized one-on-one enrollment assistance through local partner programs (such as SHIPs, AAAs, ADRCs, and BECs) when requested;
Provide a way for the public to locate and access local assistance; and
Provide a means for local partner agency such as SHIPs, AAAs, ADRCs, and BECs to enhance their benefits eligibility, screening, and enrollment assistance work helping them reach and assist beneficiaries in more efficient ways.
The NCBOE should maintain access to an online integrated care decision support tool that allows the network to enhance their counseling activities with up-to-date, state-specific and searchable information. This tool should be available to the network at no cost; provide the latest program information in real-time; allow customized searches; and be supported by a help desk, as well as, provide training videos and webinars to help tool users.
Applicants should provide a clear timeline for the development and implementation of these web-based tools. To encourage the broad use of these tools, the applicant should provide plans to conduct training and provide technical assistance to state MIPPA grantees, Benefits Enrollment Centers, SHIPs, ADRCs, other state and federal partners, and the general public. These plans should include integrating with state aging and disability network efforts, where possible. Additionally, applicants should provide appropriate outreach and education plans for dissemination of and use of tools by beneficiaries.
Establish Benefit Enrollment Centers
A central component of the NCBOE is the creation and support of local Benefit Enrollment Centers (BECs), which provide direct service though the provision of benefits information and enrollment assistance to the public at the local level. The focus of the BECs should be on assisting lower income older adults, individuals with disabilities, and Medicare beneficiaries with federal and state programs to assist with things such as housing costs, food assistance, and programs to help them pay for their Medicare costs. The BECs should work with the SHIP, MIPPA, and ADRC state grantees in their local areas to collaborate on efforts and avoid duplication. The applicant will be responsible for:
Establishing a detailed plan to compete, manage, and support a network of locally-based BEC sub-grantees;
Providing training and technical assistance to BECs to ensure that they are capable of providing skilled, one-on-one consumer assistance, as well as outreach and application assistance to eligible beneficiaries;
Developing a plan for nationwide coverage that identifies national, state and community-level collaborations, especially involving SHIPs, AAAs, Centers for Independent Living (CILs), and ADRCs;
Ensuring that the collaborative efforts mentioned above enhance the outreach and enrollment efforts conducted by all parties while avoiding duplication (for example, collaborations with SHIP could have the BEC focusing on education of housing and food assistance benefits while the SHIP focuses on the Medicare benefits available);
Developing a plan to track and report to ACL the work done by the BECs including the number of outreach events and enrollment assistance conducted;
Creating a plan to monitor the BECs on a regular basis to determine effectiveness, best practices, challenges, and other technical assistance needs in a timely manner; and
Providing regular updates to ACL on performance and challenges of the BECs.
As part of the application, the applicant should provide extensive details on how they plan to:
Ensure this national network will target hard to reach populations, including any possible referral partnerships to support the network;
Compete and/or award the sub-grants; and
Track the results of the sub-grantees to ensure that the applicant can report on the work that the sub-grantees complete.
Benefit Enrollment Centers provide essential access functions to multiple populations. In a similar fashion, each state manages and coordinates a statewide access delivery system to long-term services and supports as part of a state’s No Wrong Door (NWD) system. Applicants should describe how the BECs will coordinate within a state’s NWD System. Some examples of coordination could include: participating in a state NWD Governance Team/Structure, ensuring that BECs are part of a state’s statewide I&R consumer database, or participating in NWD person centered thinking, planning and practice training. For more information about a state’s NWD system please visit NWD website at https://nwd.acl.gov/.
Provide MIPPA Program Information and Technical Support
Applicants should provide plans to address, in conjunction with ACL, inquiries from state MIPPA grantees for information, guidance, or technical assistance in a timely manner. In addition, applicants must provide a strategy for ensuring the NCBOE remains abreast of current developments in Medicare, healthcare trends, integrated care, and related beneficiary issues, as well as a plan to ensure these developments are shared with the MIPPA network.
Successful applicant plans should:
Ensure responsive, integrated support of the MIPPA program that promotes and enhances the efficiency of grantee operations and the quality of MIPPA results;
Provide a streamlined and seamless gateway for MIPPA project grantees to access needed resources, information and technical support via an NCBOE website, publications, and other innovative and effective communications strategies;
Develop and implement training to enhance MIPPA efforts to perform key MIPPA program functions, including easily replicable and proven effective methods of conducting Medicare outreach, and counseling and education on the full range of options for Medicare beneficiaries, their families, and caregivers;
Develop and offer regular trainings about MIPPA Performance Measures including how the measures, along with data validation and quality assurance efforts, can be used to improve program management. Current Performance Measures include: Overall MIPPA Contacts; Overall Persons Reached through Outreach; MIPPA Target Populations (Under 65, Rural, Native American, English as a Secondary Language); and Contacts with Applications Submitted;
Track and analyze guidance from administering federal agencies to provide technical assistance for the states as it relates to streamlining access to benefits and services; and
Detail specific approaches, roles and activities to enhance team member training support including soliciting input from state grantees, disseminating materials developed, conducting webinar trainings and coordinating updates of the program, as needed.
Outreach and Enrollment Support to MIPPA Grantees
Applicants should develop plans, materials, products, and other items intended to assist MIPPA state grantees and local Benefit Enrollment Centers with utilizing cost-effective strategies to find Medicare beneficiaries with greatest economic need and enroll the individuals in the programs for which they are qualified. Strategies could include but are not limited to media campaigns, online outreach campaigns, innovative partnerships, and data mapping. Additionally the applicant should work with ACL to provide technical assistance to MIPPA state grantees and BECs to:
Expand related services in each state to achieve statewide coverage;
Find and reach Medicare beneficiaries with greatest economic need to assist them with benefits and enrollment assistance;
Provide assistance and/or guidance to develop innovative partnerships at the state and local level to increase the number of beneficiaries reached, including AAAs, ADRCs, CILS, and SHIPs;
Develop strategies to reach additional beneficiaries; and
Aid with the dissemination of best practices and resources for outreach and application assistance.
Applicants should collaborate with ACL and federal agency partners administering benefits programs to educate grantees and beneficiaries on the programs and, where possible, look for opportunities to streamline processes for older adults and persons with disabilities. Applicants should develop plans and coordinate efforts to inform grantees about benefits available under federal and state programs. This includes the provision of training and technical assistance, in collaboration with ACL, CMS, the National SHIP Technical Assistance Center, and other partners, on effective outreach, screening, enrollment and follow-up strategies.
Additionally to enhance the work of state partners, the NCBOE should plan to provide a public-facing portion of their website. The public-facing portion of the site should improve the public’s understanding of the nature of benefits and services and impact of the program(s). Applicants for this funding opportunity should demonstrate the ability to promote understanding of the mission of government programs to wide audiences.
Develop and Maintain a Web-Based Information Clearinghouse
Another key function of the NCBOE is the development and maintenance of a web-based information clearinghouse and library. Applicants should outline how they will fulfill this function along with clear plans to publish, advertise, or otherwise make publicly visible the web-based information clearinghouse for wide distribution and use. This includes the provision of training and technical assistance regarding the content and use of the web-based information to state MIPPA grantees, Benefits Enrollment Centers, and other state and federal partners.
This clearinghouse should include:
Best practices from state MIPPA grantees and BECs on outreach and enrollment strategies;
Strategies for online counseling and outreach;
Innovative ideas for state level collaborations, such as data sharing;
Cost-effective methods and tools for finding and enrolling older individuals with greatest economic need in the programs for which the individuals are eligible; and
Educational and training materials for the network on key state and federal benefits programs, Medicare, and integrated care programs.
Collaborate with ACL Resource Centers
ACL funds a number of resource and technical assistance centers focused on a variety of specialized topics and programs. Examples include the Senior Medicare Patrol National Resource Center, National Center for Benefits Outreach and Enrollment, AT3 Center, No Wrong Door (NWD) System initiative, National Center on Elder Abuse, and National Resource Center on LGBT Aging. While each resource center has its own mission, focus, and special target population it is important for each to work together on collaborative efforts that are mutually beneficial to support the work being done by all. This allows each to benefit from the specialist subject matter experts found within each group throughout the network. Successful applicants to this funding opportunity should provide a plan to work collaboratively with the other ACL resource centers to help enhance the capacity of all. For example, applicants could provide plans for coordinating with the NWD System initiative at the state level to ensure BECs and MIPPA grantees are a part of the NWD governance system.