In the past, Medicare saturated its enormous customer base of over 40 million Americans with an array of complex mailings on an annual basis. To better understand its information and correspondence flow, the agency embarked on a comprehensive communications audit. CitizenR&D analyzed the effectiveness of typical communiqués across various media channels such as print, web, and call center scripts. The team conducted workshops with Medicare staff to explore policy and design options. The final report outlined policy and guidelines for a more user-centered approach to beneficiary communications that ultimately improves the dialogue between Medicare and patients.