Key Takeaways

  • Large services areas, low population density, lack of public transportation, and limited infrastructure are key barriers to conducting Medicare benefits outreach in rural areas.

  • The Nebraska SHIP has partnered with community colleges and local cooperative extensions to expand their footprint into rural communities.

  • For effective rural outreach, find a partner offering something your agency lacks, be it facilities, good technology, or trust among the local target audience.

Agencies that serve rural communities have learned to contend with many barriers to successful outreach, including large services areas, low population density, lack of public transportation, limited facilities and infrastructure, and residents’ hesitancy to accept assistance. 

For over 15 years, the Nebraska State Health Insurance Assistance Program (SHIP) has developed an integrated and mutually beneficial partnership with state and local education institutions to assist with rural outreach. Keep reading to:

  • Learn how they countered obstacles to reaching rural residents
  • Get tips on what to look for when seeking a rural partner   

What makes rural outreach difficult?     

Cost to the program 

Many Medicare Improvements for Patients and Providers Act (MIPPA) grantees serving rural areas report that a disproportionate percentage of the agency’s budget must be used to pay for counselors to travel to rural areas. The high travel cost often reduces the program’s ability to fund other types of outreach efforts. 

Time commitment

Serving rural communities also requires a significant amount of time for counselors to travel to and from events, which reduces the amount of time available to conduct events. Grantees must negotiate the level of investment to make in rural outreach, recognizing that rural communities require more time and investment but often yield fewer applications when compared to more urban areas.

Desire for local assistance 

Agencies that work with the aging and disability communities recognize consistent and frequent interaction is the best way to build trust. Building strong community connections has been hampered by the closure of the government offices in rural communities. These closures have reduced the number of locals available to educate residents on the value of benefits.

This is especially damaging because word of mouth, such as referral from a friend or family member, goes a long way to reduce the stigma and hesitancy around applying for benefits.

Grantees continue to try to overcome this obstacle by recruiting additional volunteers to increase the number of trusted program champions.    

Lack of infrastructure 

Traditional mailings, flyers, and local advertisements continue to be the mainstay of outreach as many rural residents do not have reliable internet or cell service. For some, the tele-communication infrastructure is not available, while other rural residents cannot afford the cost. As a result, many rural residents do not have access to websites, educational events, or online tools unless they travel to a library or community center. In many small towns and rural communities, local newspapers, radio, and television outlets are closing. Sadly, these closings mean rural residents lose a trusted and reliable source of information, while aging and disability organizations lose a key outlet for community connection and outreach. 

How the Nebraska SHIP partnered with community colleges to improve rural outreach

The Nebraska SHIP first partnered with University of Nebraska, Lincoln in 2006 to educate Nebraskans on the new Medicare Part D benefits. Since that time, the educational partnership program has expanded to over 30 locations, including Nebraska University extension campuses, regional community colleges, and community learning centers. With the help of its educational partners, SHIP has made its outreach and educational events accessible to nearly every county in the state. 

Most schools offer both in-person and remote classes and/or events. The remote classes usually have participants come to a classroom or computer lab on campus where students can watch the Medicare presentation on a large screen or computer.  Students have access to school’s computers, internet connection and IT support to troubleshoot any technical issues.

In addition to providing the facility, the colleges also manage the registration and advertisement of the SHIP classes, which are included the continuing education and adult learning course catalog. The course catalogs are widely distributed in the local community and are also available online. The schools reported being excited to include Medicare classes in their course offerings because it brought a new demographic of older adults to the campus, which was a population the schools had been looking to serve. 

Since each school system operates independently, Nebraska SHIP has to contract separately with each institution to host their Medicare classes, enrollment events, volunteer training, and partnership-building events. Costs vary by school system, but typically, NE SHIP pays a room rental fee, which ranges from $50-$300, and the program also covers the course tuition fee for attendees, which typically ranges from $0-$15/person. 

With the help of the educational partners, NE SHIP has been able to increase their program’s reach across the state. The classes continue to prompt increases in call volume and attendance at biweekly webinars, as Nebraskans want additional information on Medicare.  The program continues to expand into more learning centers and NE SHIP hopes to soon launch an internship program with several of the partnering schools. 

A good partner is one where the partner provides something that your agency lacks."

Attributes of a promising rural partner

The Nebraska SHIP offers that a good partner is one where the partner provides something that you lack. For example, the educational partners provide facilities, technology, and advertising, three resources that SHIP needed.  In turn, SHIP is able to offer Medicare classes, which is a draw for the target population (older adults) that the educational partners were trying to reach. The Medicare classes brought a new demographic to the campus. 

Below is a summary of the attributes that grantees commonly look for when seeking a rural partner and/or developing a rural outreach strategy. Not all attributes may be appropriate in all communities but may be helpful as you consider a new rural partnership or outreach strategy. 

A promising rural partner:  

  • Is highly respected in the community
  • Increases the number of local formal or informal program champions 
  • Expands the reach of your organization
  • Provides a physical local presence
  • Provides a connection to an unserved population 
  • Operates cost effectively  
  • Provides resources that your organization lacks 
  • Shares the mission of providing unbiased information and resources to the community 
  • Communicates what is working and not working in the partnership  

For more information on Nebraska’s education partnerships, contact Jonathan Burlison.