eligibility for Medicaid and other public programs. Program staff are also trained to help participants complete claims forms and file appeals. Currently, all states have ICA programs, which are staffed through a combination of paid staff and volunteers.
Funding for these organizations, however, has always been limited and is an area of concern. Communications programs require substantial resources. One potential source of funding for these centers or similar counseling programs would be the Medicare program itself, in which consumer education funds could be deemed a priority.
Other organizations, such as the United Seniors Health Cooperative, operate counseling programs to educate seniors about their health care options. The health insurance counseling program for United Seniors receives calls and letters from seniors all over the country. 33
National surveys on consumer satisfaction in Medicare HMOs have been conducted, but the information they offer is limited, and there are concerns that they are not useful indicators of the quality of care that an HMO provides.
An early study comparing the satisfaction of Medicare beneficiaries in HMOs with that of beneficiaries in traditional fee-for-service plans showed that a high percentage—about 80 percent—of both groups were "very satisfied" with their health care overall (Rossiter et al., 1989). In general, satisfaction surveys of HMO members indicate that they are more satisfied than their counterparts in fee-for-service plans with the out-of-pocket expenses and the reduced paperwork in managed care plans. They are less satisfied with access to care, referrals to specialists, and physician choice.