Consumer perspectives on information needs for health plan choice (original) (raw)
Related papers
The Center for Medicare & Medicaid Services (CMS) initiated the National Medicare Education Program (NMEP) in 1998, aiming to collect information of quality from contracted managed care plans and disseminate it to Medicare beneficiaries. Before evaluating these CMS efforts, it is necessary to understand what quality information was publicly available before the NMEP, how such information affected Medicare enrollment during pre-NMEP periods, and how such information correlated with the information collected by CMS. This paper answers these questions by examining the publicly available information from the National Committee of Quality Assurance (NCQA). Specifically, we find that (1) CMS efforts provide extra information on managed care quality but do not replace the public-accessible NCQA information; (2) although NCQA information already had a strong correlation with Medicare enrollment during pre-NMEP periods, it was not utilized to the full extent. In particular, publicly released NCQA data on plan performance contributed to the enrollment shift from fee-for-service to managed care, but did not draw clear distinction among competing managed care plans. These findings suggest that NMEP may have great potential in separating good managed care plans from bad ones, but will have a limited ability in generating further switches from fee-for-service to managed care.
Health plan decision making with new medicare information materials
2001
OBJECTIVE: To examine the effect of providing new Medicare information materials on consumers' attitudes and behavior about health plan choice. DATA SOURCE: New and experienced Medicare beneficiaries who resided in the Kansas City metropolitan statistical area during winter 1998-99 were surveyed. More than 2,000 computer-assisted telephone interviews were completed across the two beneficiary populations with a mean response rate of 60 percent. STUDY DESIGN: Medicare beneficiaries were randomly assigned to a control group or one of three treatment groups that received varying amounts and types of new Medicare information materials. One treatment group received the Health Care Financing Administrations's pilot Medicare & You 1999 handbook, a second group received the same version of the handbook and a Medicare version of the Consumer Assessment of Health Plans (CAHPS) report, and a third treatment group received the Medicare & You bulletin, an abbreviated version of the handbo...
Health services research, 2001
Social marketing techniques such as consumer testing have only recently been applied to develop effective consumer health insurance information. This article discusses lessons learned from consumer testing to create consumer plan choice materials. Data were collected from 268 publicly and privately insured consumers in three studies between 1994 and 1999. Iterative testing and revisions were conducted to design seven booklets to help Medicaid, Medicare, and employed consumers choose a health plan. Standardized protocols were used in 11 focus groups and 182 interviews to examine the content, comprehension, navigation, and utility of the booklets. A method is suggested to help consumers narrow their plan choices by breaking down the process into smaller decisions using a set of guided worksheets. Implementing these lessons is challenging and not often done well. This article gives examples of evidence-based approaches to address cognitive barriers that designers of consumer health ins...
Role of consumer information in today's health care system
Health care financing review, 1996
This overview discusses articles published in this issue of the Health Care Financing Review, entitled "Consumer Information in a Changing Health Care System." The overview describes several trends promoting more active consumer participation in health decisions and how consumer information facilitates that role. Major issues in developing consumer information are presented, stressing how orientation to consumer needs and use of social marketing techniques can yield improvement. The majority of the articles published in this issue of the Review discuss different aspects of information for choice of health plan, ranging from consumer perspectives on their information needs and their comprehension of quality indicators, to methods used for providing such information, such as direct counseling and comparative health plan performance data. The article concludes with thoughts on how we will know if we succeed in developing effective consumer health information.
Can a More User-Friendly Medicare Plan Finder Improve Consumers' Selection of Medicare Plans?
Health services research, 2016
To evaluate the efficacy for consumers of two potential enhancements to the Medicare Plan Finder (MPF)-a simplified data display and a "quick links" home page designed to match the specific tasks that users seek to accomplish on the MPF. Participants (N = 641) were seniors and adult caregivers of seniors who were recruited from a national online panel. Participants browsed a simulated version of the MPF, made a hypothetical plan choice, and reported on their experience. Participants were randomly assigned to one of eight conditions in a fully factorial design: 2 home pages (quick links, current MPF home page) × 2 data displays (simplified, current MPF display) × 2 plan types (stand-alone prescription drug plan [PDP], Medicare Advantage plan with prescription drug coverage [MA-PD]). The quick links page resulted in more favorable perceptions of the MPF, improved users' understanding of the information, and increased the probability of choosing the objectively best plan....
Evaluating health plan quality 2: Survey design principles for measuring health plan quality
The American journal of managed care
hysicians offer an important viewpoint on health plan quality. 1 The physician viewpoint is important not only because physicians can provide unique and timely information but also because the physician viewpoint can be used to corroborate other measures. 1-4 Physicians observe the point where health plan processes and structures (eg, utilization review, profiling, formularies, guidelines, provider networks) meet patients. In addition to this unique vantage point, physicians have a distinct blend of diagnostic and therapeutic knowledge, training, skills, and normative commitments. 4,5 Consequently, physicians can provide an important perspective on how healthcare is managed within a health plan, an assessment of quality, and a timely, early warning about possible problems relating to utilization management. Our goal was to develop a survey instrument that obtains the physician's perspective on health plan quality and that results in information that is informative and useful to consumers, health plans,
Public Reporting in Health Care: How Do Consumers Use Quality-of-Care Information?
Medical Care, 2009
Background: One of the underlying goals of public reporting is to encourage the consumer to select health care providers or health plans that offer comparatively better quality-of-care. Objective: To review the weight consumers give to quality-of-care information in the process of choice, to summarize the effect of presentation formats, and to examine the impact of quality information on consumers' choice behavior. The evidence is organized in a theoretical consumer choice model. Data Sources: English language literature was searched in PubMed, the Cochrane Clinical Trial, and the EPOC Databases (January 1990-January 2008). Study Selection: Study selection was limited to randomized controlled trails, controlled before-after trials or interrupted time series. Included interventions focused on choice behavior of consumers in health care settings. Outcome measures referred to one of the steps in a consumer choice model. The quality of the study design was rated, and studies with low quality ratings were excluded. Results: All 14 included studies examine quality information, usually CAHPS, with respect to its impact on the consumer's choice of health plans. Easy-to-read presentation formats and explanatory messages improve knowledge about and attitude towards the use of quality information; however, the weight given to quality information depends on other features, including free provider choice and costs. In real-world settings, having seen quality information is a strong determinant for choosing higher quality-rated health plans. Conclusions: This review contributes to an understanding of consumer choice behavior in health care settings. The small number of included studies limits the strength of our conclusions.
Health Services Research, 2003
Objective. To estimate the reliability and validity of survey measures used to evaluate health plans and providers from the consumer's perspective. Data Sources. Members (166,074) of 306 U.S. health plans obtained from the National CAHPS s Benchmarking Database 2.0, a voluntary effort in which sponsors of CAHPS s surveys contribute data to a common repository. Study Design. Members of privately insured health plans serving public and private employers across the United States were surveyed by mail and telephone. Interitem correlations and correlations of items with the composite scores were estimated. Planlevel and internal consistency reliability are estimated. Multivariate associations of composite measures with global ratings are also examined to assess construct validity. Confirmatory factor analysis is used to examine the factor structure of the measure. Findings. Plan-level reliability of all CAHPS s 2.0 reporting composites is high with the given sample sizes. Fewer than 170 responses per plan would achieve plan-level reliability of .70 for the five composites. Two of the composites display high internal consistency (Cronbach's alpha 4 5 .75), while responses to items in the other three composites were not as internally consistent (Cronbach's alpha from .58 to .62). A fivefactor model representing the CAHPS s 2.0 composites fits the data better than alternative two-and three-factor models. Conclusion. Two of the five CAHPS s 2.0 reporting composites have high internal consistency and plan-level reliability. The other three summary measures were reliable at the plan level and approach acceptable levels of internal consistency. Some of the items that form the CAHPS s 2.0 adult core survey, such as the measure of waiting times in the doctor's office, could be improved. The five-dimension model of consumer assessments best fits the data among the privately insured; therefore, consumer reports using CAHPS s surveys should provide feedback using five composites.