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Adding CAHPS® data to standard enrollment materials does not affect health plan choice among new Medicaid enrollees

Providing newly enrolled beneficiaries in the Iowa Medicaid Program with consumer assessments of various health plans within the program (via the Consumer Assessment of Health Plans Study [CAHPS®]) in addition to standard Medicaid enrollment materials did not affect their plan choices, according to a recent study. The findings to date suggest that the value of CAHPS® information may be limited to a subset of receptive consumers who actively study health plan information and, even then, only when ratings of available plans differ greatly, ratings differ from prior beliefs about plan quality, and reports are easy to understand, conclude the RAND researchers who conducted the study.

In a study that was supported in part by the Agency for Healthcare Research and Quality (HS09204), the researchers randomly assigned new Medicaid enrollees in three Iowa counties to experimental or control groups. The control group received standard Medicaid enrollment materials, and the experimental group received these materials plus a CAHPS® report for MediPASS, a primary care case management program, and one or two health maintenance organizations (HMOs). The CAHPS® report included consumer ratings of primary and specialty care and plan experience, for example, ease of getting an appointment or specialty referral when needed.

Under Iowa Medicaid rules, new beneficiaries in counties with more than one HMO were randomly assigned with equal probability to one of the two HMOs as their default HMO. In general, most beneficiaries (77 percent) remained in the default plan to which they were initially assigned. Beneficiaries in the counties with three plan choices were more likely to remain in the default plan (80 percent) than those in the counties with only two choices (75 percent). The CAHPS® information had no significant effect on the rates at which beneficiaries switched out of a default plan into another option.

More details are in "Effect of CAHPS® performance information on health plan choices by Iowa Medicaid beneficiaries," by Donna O. Farley, Ph.D., Marc N. Elliott, Ph.D., Pamela Farley Short, Ph.D., and others, in the September 2002 Medical Care Research and Review 59(3), pp. 319-336.

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