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Medicare's online drug benefit plan: six lessons not learned.

Article Excerpt
My fall 2004 column (1) noted that Medicare patients were not signing up as expected for their Medicare drug benefit cards because they were so confused by the card selection process. Unfortunately, Medicare's new drug benefit plan doesn't seem to be any easier for patients to understand than was the 2004 plan.

Six Usability Lessons Not Learned

I. Not Understanding Beneficiary's Educational Attainment

Medicare's new drug benefit plan has already been described as being too complicated for many patients to figure out. But patients will have problems not only with the plan itself, but how plan information is presented on the medicare.gov Web site. Do Medicare patients have the educational background to complete the tasks required to select a drug benefit plan? Exhibit 1 shows the educational attainment of adults 65 and older; 65 year-old Medicare patients graduated high school in 1958; 75 year-olds in 1948; 85 year-olds in 1938. Exhibit 2 shows the prose, document, and quantitative literacy skills of adults 65 and older from the 2003 National Assessment of Adult Literacy (http://nces. ed.gov/naal). Will elderly patients with these levels of educational attainment and literacy skills have the analytical skills to interpret all the narrative, financial, and statistical information about Medicare's drug benefit plan?

While some Medicare patients may expect some help from their children, older Medicare patients (80-90) probably have friends about their age, and may even have children who are 60 years old or older. But their adult children may not have the computer skills needed to use the Web site so they may have to rely on their grandchildren.

Because Medicare's Web site violates basic usability and document design recommendations, Medicare beneficiaries will have a very hard time using the site. Exhibit 3 points out some of the discrepancies between Web site features and usability recommendations.

Paradoxically, Medicare & You 2005 which is sent to all Medicare beneficiaries is much more consistent with document design recommendations, averaging 63 characters per line, 12 words...

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