The Medicare population is very diverse. Forty percent are over the age of 75, and 48 percent are between the ages of 65 and 74. Fifty-one percent still live with their spouses, while 27 percent live alone and 5 percent live in a long-term-care facility. Forty-six percent have had 12 or more years of education, but 27 percent have had less than 8 years of education (U.S. Department of Health and Human Services, 1997b).
This degree of diversity contributes to the difficulty that marketing experts find in conveying a simple message to senior citizens in the United States (Lumpkin et al., 1989). Several of the panelists* indicated that in their experience only two or three factors may influence the health plan decisions made by adults who are not senior citizens. However, their work with senior citizens shows almost no consensus on the range of factors that influence that group's decisions.
The Medicare population is very diverse. This degree of diversity contributes to the difficulty that marketing experts find in conveying a simple message to senior citizens in the United States.
Bruce Clark and other presenters and participants at the workshop stressed that HCFA must bear in mind the local nature of health care. Different communities have different health care needs and concerns. The panel on marketing indicated that the current trend in private-sector marketing is to move away from mass marketing and toward "mass customization," in which companies reach their customers by building more personal marketing strategies. Successful private-sector marketing to the Medicare population has become more individualized. Companies and plans target potential enrollees along the lines of socioeconomic status, neighborhoods, ethnic groups, language, and religious affiliations. HCFA, however, does not have the financial or personnel resources to target its materials to every subgroup within the Medicare population, and the panelists presented a clear caution to the committee: The size and time line of HCFA's current task will compel the agency to standardize the Medicare+Choice information to the greatest extent possible. At the same time, health plans will be sending customized marketing materials to these same beneficiaries. The committee heard evidence that to help stem the confusion that will result from beneficiaries trying to understand all of the different pieces of information that they will receive, HCFA and the private sector should be encouraged to work together to build a more cohesive and useful information infrastructure.
Members of the panel suggested that the marketing dilemma might be addressed by segmenting the Medicare population into at least two groups: those over age 70 and those under age 70 or those beneficiaries who are more familiar with managed care through their former employment status and those who are of an age such that they have not had prior experience with managed care. It is worth noting that the under-70 age group tends to be more active and more Internet savvy, and tends to rely less on family members and doctors for advice on choosing a health plan. Others at the workshop suggested that segmentation by health status might be more