Brown University, Providence, Rhode Island, USA.
Department of Health Services, Policy and Practice, Brown University School of Public Health, 121 S. Main St. 6th floor, Box G-121-6, Providence, Rhode Island, 02912, USA.
BMC Geriatr. 2023 Jan 12;23(1):23. doi: 10.1186/s12877-022-03674-4.
The COVID-19 pandemic resulted in unprecedented challenges for older adults. Medicare enrollment was already an overwhelming process for a high fraction of older adults pre-pandemic. Therefore, the purpose of this qualitative study was to gain understanding from community organizations and stakeholders about their pre-pandemic and during-pandemic experiences while adapting to continue offering insurance advice to seniors, what resources are available to seniors, and what needs to be done to help seniors make higher quality insurance choices in the Medicare program. In addition, we wanted to explore how the COVID-19 pandemic may have changed the ways that these stakeholders interacted with Medicare beneficiaries.
We employed a qualitative strategy to gain a deep understanding of the challenges that these organizations may have faced while offering advice/counseling to older adults. We accomplished this by interviewing a group of 30 stakeholders from different states.
Every stakeholder mentioned that some older adults have difficulty making Medicare decisions, and 16 stakeholders mentioned that their system is complex and/or overwhelming for older adults. Twenty-three stakeholders mentioned that Medicare beneficiaries are often confused about Medicare, and this is more noticeable among new enrollees. With the onset of the pandemic, 22 of these organizations mentioned that they had to move to a virtual model in order to assist beneficiaries, especially at the beginning of the pandemic. However, older adults seeking advice/meetings have a strong preference for in-person meetings even during the pandemic. Given that the majority of the beneficiaries that these stakeholders serve may not have access to technology, it was difficult for some of them to smoothly transition to a virtual environment. With Medicare counseling moving to virtual or telephone methods, stakeholders discussed that many beneficiaries had difficulty utilizing these options in a variety of ways.
Findings from our interviews with stakeholders provided information regarding experiences providing Medicare counseling pre- and during-COVID-19 pandemic. Some of the barriers faced by older adults included a complex and overwhelming system, a strong preference for in-person meetings among beneficiaries, challenges with technology, and an increased risk of information overload and misinformation. While bias may exist within the study and sample, given that technology-savvy beneficiaries may not seek help from organizations our study participants work in, they show how the current Medicare system may impact vulnerable older adults who may need support with access to high-speed internet and digital literacy.
COVID-19 大流行给老年人带来了前所未有的挑战。在大流行之前，对于很大一部分老年人来说，医疗保险的参保已经是一个压倒性的过程。因此，这项定性研究的目的是从社区组织和利益相关者那里了解他们在大流行前和大流行期间的经验，了解他们如何适应继续为老年人提供保险建议，老年人可以获得哪些资源，以及需要做些什么来帮助老年人在医疗保险计划中做出更高质量的保险选择。此外，我们还想探讨 COVID-19 大流行如何改变了这些利益相关者与医疗保险受益人的互动方式。
我们采用定性策略，深入了解这些组织在为老年人提供建议/咨询时可能面临的挑战。我们通过采访来自不同州的 30 名利益相关者来完成这项工作。
每位利益相关者都提到，一些老年人在做出医疗保险决策方面有困难，16 位利益相关者提到他们的系统对老年人来说复杂且/或难以理解。23 位利益相关者提到，医疗保险受益人经常对医疗保险感到困惑，而新参保者更为明显。随着大流行的爆发，其中 22 家组织提到，为了帮助受益人，他们不得不转向虚拟模式，尤其是在大流行初期。然而，寻求建议/会议的老年人强烈偏好面对面会议，即使在大流行期间也是如此。鉴于这些利益相关者服务的大多数受益人可能无法使用技术，因此他们中的一些人很难顺利过渡到虚拟环境。随着医疗保险咨询转向虚拟或电话方式，利益相关者讨论了许多受益人在各种方面难以使用这些选项。
我们对利益相关者的访谈结果提供了有关在 COVID-19 大流行前后提供医疗保险咨询的经验信息。老年人面临的一些障碍包括系统复杂且难以理解、受益人强烈偏好面对面会议、技术挑战以及信息过载和错误信息的风险增加。虽然研究和样本中可能存在偏见，但由于精通技术的受益人可能不会寻求他们所在组织的帮助，因此我们的研究参与者展示了当前的医疗保险系统如何影响可能需要支持来获得高速互联网和数字扫盲的弱势老年人。
