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People vary in what they look for when choosing a health plan

Consumers with all types of health insurance realize the importance of choosing a good health plan and usually obtain information about plans from several sources, including family and friends. However, insured groups vary in what they value most when choosing a health plan, according to a study supported in part by the Agency for Healthcare Research and Quality (HS09218).

People insured by State Medicaid programs cared most about convenience and access to care, while the privately insured had more of a stake in their personal relationship with a doctor and out-of-pocket costs. Also, Medicare and Medicaid recipients found choosing a plan more difficult than people with private insurance.

Groups developing traditional plan enrollment materials and health plan evaluation reports, such as the Consumer Assessment of Health Plans Study (CAHPS®), probably need to tailor how they inform these different insurance groups about health plan options. For example, Medicaid reports should emphasize the accessibility and convenience of services, suggests principal investigator Lauren Harris-Kojetin, Ph.D., of Research Triangle Institute. The researchers explored the reactions to and use of traditional health plan enrollment materials and CAHPS® reports among 10,000 consumers with employer-sponsored, Medicaid, and Medicare health plans using data from eight CAHPS® demonstrations.

Keeping your own doctor (or finding one you are happy with) and keeping out-of-pocket costs low ranked as two of the top five considerations for privately insured groups but were not relevant for Medicaid consumers, who are most concerned about convenience and access to care. One area that was a high priority for both Medicaid and privately insured consumers was "doctors who communicate well." Areas of high priority for Medicare respondents were ease of getting medical help in the evenings and on weekends, access to "good" specialists, a conveniently located doctor's office, and enough time with doctors.

See "Similarities and differences in choosing health plans," by Pamela Farley Short, Ph.D., Lauren McCormack, Ph.D., Judith Hibbard, Dr.P.H., and others, in Medical Care 40(4), pp. 389-302, 2002.

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