title: Medicare beneficiary knowledge of the Part D program and its relationship with voluntary enrollment.
abstract: BACKGROUND
  The 2003 Medicare Modernization Act established the Part D drug benefit in 2006. Because the benefit involves a voluntary enrollment process with numerous plan options, there has been concern about whether beneficiaries have adequate knowledge of the program, but research on this issue has been limited.
  
  
  OBJECTIVE
  To examine Medicare beneficiary knowledge of the Part D program and estimate how knowledge affected voluntary enrollment decisions at the program's outset.
  
  
  METHODS
  We linked data from the 2005 Medicare Current Beneficiary Survey with CMS administrative data regarding beneficiary 2006 drug coverage and market characteristics. We estimated a multivariate logistic regression model to explore the relationship between Part D knowledge and beneficiaries' voluntary enrollment in a Part D plan.
  
  
  RESULTS
  At the inception of the Medicare Part D benefit, no single knowledge test question was correctly answered by more than three-fourths of beneficiaries. Correct responses to five knowledge test questions were positively associated with enrollment: "everyone has plan choices" (adjusted odds ratio = 1.4); "plans can change costs once per year" (aOR = 1.2); "beneficiaries must use plan pharmacies" (aOR = 1.5); "beneficiaries must pay a penalty if they enroll late" (aOR = 1.3); "assistance is available for low income beneficiaries" (aOR = 1.2).
  
  
  CONCLUSIONS
  Beneficiary understanding of the Part D program in early 2006 was limited. Beneficiary knowledge of Part D program details was associated with enrollment in Medicare Part D. Efforts to educate Medicare beneficiaries about Part D may improve rates of prescription drug coverage.
authors.affiliation: Centers for Medicare & Medicaid Services.
authors.forename: Benjamin Lee
authors.initials: BL
authors.lastname: Howell
authors.affiliation: Johns Hopkins Bloomberg School of Public Health.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wolff
authors.affiliation: Johns Hopkins Bloomberg School of Public Health.
authors.forename: Bradley
authors.initials: B
authors.lastname: Herring
mesh_terms: D003625:Data Collection; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D054524:Medicare Part D / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: Demand; Medicare Coverage Decisions, Medicare, Access; Utilization of Services