Public Reporting Formats
That Motivate Older
Consumers to Compare
Medicare Health Plan Options
Presented at
AcademyHealth 2004
Presented by Nancy Mitchell
San Diego, CA
June 6-8, 2004
1615 M Street, NW · Suite 740 · Washington, DC 20036
Phone: 202-728-2082 · Fax: 202-728-2095 · nmitchell@rti.org · www.rti.org
Authors and funding


2
Authors:

Nancy Mitchell, BA

Elizabeth Frentzel, MPH

Jennifer D. Uhrig, Ph.D.

Peyton Williams, BA

Philip Salib, BA

Lauren Harris-Kojetin, Ph.D.
Supported by grant number R18 HS11008 from the
Agency for Healthcare Research and Quality
Rationale for the study
3

Approximately 200,000 persons age into Medicare every
year
 Complex health care market
 Health and financial consequences of an uniformed
choice
 Benefits of using comparative quality information

Employers are in a position to counsel Medicare-eligible
employees and retirees
 No standard method across employers to accomplish
this
 Current materials do not integrate cost, benefits,
quality and rules
 Current materials are very detailed
Research Objectives
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
4
To develop, test and evaluate integrated print- and
web-based materials to assist pre-Medicare
employees and retirees in choosing a Medicare
health plan

Conducted formative research

Developed, cognitively tested and evaluated
materials
This presentation will focus on the development and
cognitive testing of the materials
Theoretical Application
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5
Prochaska and DiClemente’s Stages of Change
Model

People are in 1 of 6 different stages of change

Target audience in a pre-contemplation or
contemplation stage

Developed three products to help move target
audience to action stage
Theoretical Application con’t
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6
Bettman’s Cognitive Information Processing Model

Limited ability to process information

Kept information concise

Selected content based on what consumers
report as most helpful for choosing a health plan

Sensitive to reading level and format style
Methods

Materials reviewed by consumer reporting experts

5 rounds of cognitive testing interviews conducted
with 48 employees and retirees
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7

Ages 58 – 64

In Oregon, North Carolina, and Washington, DC
Materials revised after each round of review and
testing
Product 1: Bookmark
8
Product 2: Booklet
9
Product 3: Booklet and
Interactive Website
1
Principal Findings
Mechanics of the Presentation
1

Liked the idea of receiving bookmark prior to the
other products

Preferred photographs of people within their age
range

Had difficulty understanding generic descriptions of
health plan options
Principal Findings (con’t)
Mechanics of the Presentation
1

Had difficulty understanding differences in cost

Liked the look and layout of products

Used the worksheet to track factors influencing their
decisions

Trusted the information
Principal Findings (con’t)
Plan Choice
1

Reported that products were easy to use

Understood the quality data

Wanted information about whether their doctor
participated in plans
Implications for Policy and
Practice
Mechanics of the Presentation
1

Remove descriptions of generic plan types

Present only key elements of cost data

Keep information concise and eliminate non-essential
details
Implications for Policy and
Practice
Plan Choice

1
Enable employees and retirees to make a more
informed plan choice

Materials reduce complexity of factors to consider
and make the decision more manageable

Facilitate use of comparative information