wide have at least one local counseling site. The program is primarily staffed by trained volunteers, with close to 10,500 individuals across the country volunteering with ICA programs.

The ICA program served approximately 192,212 individuals via phone or one-on-one counseling during a 1-year reporting period (April 1, 1993, to March 31, 1994), with more than 400,000 people participating in a presentation or seminar. This translates to a national average of 12 persons served per 1,000 persons over age 65, although there was substantial variation by state, with proportionately high numbers of older adults served in Idaho, Montana, and New Mexico and proportionately low numbers served in Alabama, Alaska, Hawaii, and South Carolina. Five percent of the total health insurance issues raised during counseling encounters dealt with managed care questions, although states with a high level of penetration into managed care, such as California, Massachusetts, and Oregon, had higher percentages.

Private Sector

The feasibility of a counseling program is being explored under an HCFA Small Business Innovation Research (SBIR) program that funds feasibility studies for small businesses. The project is being conducted by USHC Development Corporation, a for-profit subsidiary of the United Seniors Health Cooperative (USHC), a nonprofit organization that, since 1986, has helped older persons in metropolitan Washington, D.C., be informed consumers.

The project will specifically explore the feasibility of providing a counseling service and related products designed to provide unbiased consumer information to Medicare consumers who are in the process of choosing a managed care plan, as well as a self-assessment instrument and related publications. Included in the study is an investigation of potential markets for the counseling and related products, such as the ICA programs, employers, unions, professional and retiree associations, and managed care organizations.

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