The Administration for Community Living (ACL) at the Department of Health and Human Services led a pilot of two concepts: the Federal Decision Support Guide, and the Federal Forum on Serving Older Adults.

The Federal Decision Support Guide was translated into Spanish and Chinese, and lives on ACL’s Approaching Retirement Age website. The guide was created in collaboration with community-based organizations (CBOs), and then piloted with six community-based organizations (CBOs) that work directly with older adults. During the pilot, these CBOs used the guide with clients in counseling sessions. In surveys of older adults who interacted with the guide, a majority agreed that the guide reduced their level of worry about the financial and healthcare decisions they needed to make, and made the process of obtaining benefits easier to understand.

ACL also hosted three Federal Forums with presentations by Federal agency partners, and over 380 participants. After the June Forum, most respondents agreed that the Forum increased their access to materials that will assist them in helping older adults make informed financial and healthcare decisions, and a majority agreed that their participation increased their understanding of Federal programs, increased their access to materials and tools, and will reduce the time it takes to navigate Federal resources.

In the next phase of the project, ACL plans to develop an interactive website to improve accessibility of the guide resources and continue to pilot the existing materials and the redesigned website with additional CBOs.

See the 2024 project evaluation plan to learn about the project measures and methods.

The team led the project through a complete design phase, which included designing two concepts to support older adults, their caregivers, and frontline staff: a Federal Decision Support Guide and a Federal Forum on Serving Older Adults. The team developed the concepts from sketches to prototypes throughout nine co-design sessions with national and community-based organizations and 11 cross-agency workshops. The prototypes create a foundation for agencies to transcend separate functions or departments and collaborate in new ways, which should lead to more systemic and customer-centered interventions.

• The Federal Decision Support Guide consolidates information on resources and benefits from seven agencies to help older adults, caregivers, and frontline staff make informed decisions about healthcare, finances, housing, and nutrition. It consists of modules including Federal benefits and services available, rules and considerations for eligibility, how and where to apply, and where to turn for personalized assistance. The project team developed the content collaboratively with input from HHS (both ACL and CMS), CFPB, HUD, SSA, and USDA. The team completed usability testing with six frontline staff and six members of the public.
• The Federal Forum on Serving Older Adults is a community of staff who support older adults to connect with Federal staff who work in senior-focused programs. It will center around learning through engagement, with topics that strengthen Federal understanding of how programs can better connect to on-the-ground needs, and will focus solutions on specific outreach challenges or communities that are hard to reach. The project team created a prototype of the Federal Forum and tested it through a desirability survey.

In FY 2024, the Administration for Community Living (ACL) at HHS will lead the pilot phase for both concepts. ACL will launch digital and translated versions of the resource guide and pilot its use with select community-based-organizations. Additionally, ACL will pilot a year of quarterly Community of Practice sessions, hosted collaboratively by Federal agency partners across Government.

In 2024, the Social Security Administration (SSA) and the Centers for Medicare & Medicaid Services (CMS) enhanced the customer experience for individuals aged 65 who are eligible for Medicare but not yet receiving Social Security Retirement benefits:

• SSA added a button to the Medicare application confirmation screen on SSA.gov, leading users to a new landing page and driving roughly 20,000 new enrollees to the Medicare Getting Started page each month.
• SSA and CMS together updated CMS’s Application for Enrollment in Medicare Form to obtain more information at the first point of contact and remove the need for a wet signature.
• CMS’s Office of Communications updated web content to encourage millions of people who receive a Medicare premium bill to pay their Medicare premiums online.
• CMS updated notices and handbooks that are sent to tens of millions of people annually to refer users to appropriate SSA.gov webpages instead of SSA’s 1-800 Number wherever possible, improving the customer experience of calling SSA’s 1-800 Number with questions about Medicare that SSA 1-800 Number agents are unable to address.

These changes reflect SSA and CMS’s commitment to simplifying processes, reducing administrative burdens, and improving the overall experience for Medicare beneficiaries.

In early 2023, the team conducted an extended scoping effort to identify near-term and longer-term improvements that could enhance the customer experience enrolling in Medicare-only at age 65. The team began by improving content and page design on SSA.gov and Medicare.gov. They also explored options for more process design improvements as individuals navigate the two websites and enrollment steps.

The team completed secondary research to understand when and how customers enroll in Medicare and the pain points that some people experience. The team conducted stakeholder interviews with staff from SSA operations and CMS Medicare.gov; they also shadowed telephone appointments for customers enrolling in Medicare through SSA. The team also reviewed existing reports that address improving customer experiences.

After this extended scoping phase, the team paused the effort for now due to SSA’s concerns with its resources and capacity to continue the work in the near term. The team’s work to date—including on customer insights, potential solutions to modernize and streamline the Medicare-only application process, and the in-depth confirmatory research needed to support those solutions—will inform future efforts. Additional information is provided below.

Modernizing the Enterprise Income Verification (EIV) system aims to improve HUD’s data exchanges with SSA and other Federal partners. The project improvement aims for Public Housing Agencies (PHAs) to be able to validate Social Security income in real-time rather than quarterly (the current state) to determine tenant eligibility. By increasing the frequency of data exchanges with SSA, HUD seeks to streamline processes, reduce improper payments to PHAs, and minimize the need for tenants to visit SSA field offices.

HUD received funds to modernize the EIV system in the 2023 Budget, and the IT modernization performance plan that covered these activities was approved in 2024. HUD continues coordinating with the agency’s IT modernization strategy and SSA to enhance EIV and improve customer experience.