High-Performance Partnerships - National Academy of Public ...

CAREGIVER/EMPLOYER PROJECT
CENTERS FOR MEDICARE AND
MEDICAID SERVICES
Rosalyn Carter once said there are four types
of people: those who have been caregivers,
those who currently are caregivers, those who
will be caregivers, and those who will need
caregivers.
Research shows that one in four U.S. households—about
24 million people—care for elderly
family members or friends. Medical
progress, coupled with the aging of the
Boomer generation, will increase these numbers
significantly during the next few years.
The number of caregivers is expected to total
39 million by 2007. Family caregiving now
costs the equivalent of $200 billion annually.
Sixty-four percent, or close to 15 million, caregivers
work. Fifty-five percent report that
caregiving impacts their work. They leave
work early, arrive late, and miss days. On average,
caregivers can lose more than $650,000 in
wages, social security benefits, and pensions.
Forty-five percent of employed caregivers
spend one to five hours a week providing that
care. Twenty percent spend 11 or more hours
per week. Caregiving costs employers from
$11 to 29 billion dollars per year.
The Centers for Medicare and Medicaid
Services (CMS) administers the Medicare and
Medicaid programs. CMS communicates
Medicare program information to 40 million
aged and disabled beneficiaries. This challenge
is complicated by population demographics.
Medicare information must be understandable
to older, sick, and disabled people with various
levels of education, incomes, ethnic backgrounds,
and languages. Although CMS pays
for medical services, insurance is hard to
understand. The dilemma is that people wait
to get information until there is a problem.
CMS has targeted caregivers as a key audience
to educate so they can help people to learn
about the Medicare program. Caregivers do
not identify themselves as such. They perceive
themselves as doing what is appropriate.
Identifying and reaching caregivers is a challenge,
but doing so through their worksite is
an effective approach.
In 1999, CMS established a Caregiver
Workgroup composed of caregiver and related
organizations, beneficiary advocacy groups,
disease-specific organizations, government
agencies, employers, employer intermediaries,
and others. This workgroup’s goal was to
develop effective methods of communicating
Medicare information to beneficiaries. The
primary recommendation was to develop
Medicare information for employed caregivers.
CMS partnered with these organizations and
their affiliates to develop and test Medicare informational
materials targeted to 15 million
employed caregivers and employers. The partnership’s
immediate objectives were to educate
employed caregivers about the program and help
them assist the people they care for in making
informed decisions. Caregiver and employer
partners develop and test the materials.
Employer intermediaries distribute the materials.
Partnership Characteristics
The Caregiver/Employer Project illustrates the
difficulties of operating in a national context.
The partnership’s goal is very specific, but its
structure and administrative and implementation
approach are diffuse. CMS, Caregiver
Workgroup members, and other national partners
operate in tandem with local affiliates,
employers, and employer groups.
59 Powering the Future: High-Performance Partnerships