percent in 1993 to 63 percent in 1994, the largest increase seen in the 9-year history of the survey (Foster Higgins, 1994).

With the changing options available under the Medicare program comes the need to clearly inform and educate beneficiaries about their choices in order for them to make a decision that best meets their personal needs. This paper focuses on communicating with Medicare beneficiaries over age 65 about their health plan options, with an emphasis on communicating about the topic of managed care. Information on reaching and educating disabled beneficiaries under 65 is not addressed in this paper.

The paper first reviews the literature with reference to communicating with older adults in general, including an analysis of the preferred media. The literature on communicating with older adults about health care, and managed care in particular, will then be presented. The balance of the paper includes case examples of different communications channels, including print, telephone, broadcast, video, electronic, and person-to-person, approaches used to disseminate information about health, managed care, or health plan choices. Wherever possible the examples given pertain to Medicare beneficiaries or older adults; however, in some cases they apply to all health care consumers.

The case examples, largely drawn from telephone interviews and a review of program materials, are organized by information source including public agencies (such as the Health Care Financing Administration or public libraries), nonprofit organizations, private companies, employers, and health plans. The paper is not meant to be a complete description of what these organizations do, nor is it meant to be a comprehensive review of all of the organizations that use these types of media, but rather, it is meant to highlight the range of organizations communicating with older adults about health care and the types of media that they use.

Communicating With Older Adults: Media Approaches

A discussion of the literature on communicating with older adults includes two bodies of work. The first deals with the literature relating to the use of various media to educate older



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