1. 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

2. 2 Authors and funding n Authors: l Nancy Mitchell, BA l Elizabeth Frentzel, MPH l Jennifer D. Uhrig, Ph.D. l Peyton Williams, BA l Philip Salib, BA l Lauren Harris-Kojetin, Ph.D. n Supported by grant number R18 HS11008 from the Agency for Healthcare Research and Quality

3. 3 Rationale for the study n Approximately 200,000 persons age into Medicare every year l Complex health care market l Health and financial consequences of an uniformed choice l Benefits of using comparative quality information n Employers are in a position to counsel Medicare-eligible employees and retirees l No standard method across employers to accomplish this l Current materials do not integrate cost, benefits, quality and rules l Current materials are very detailed

4. 4 Research Objectives n To develop, test and evaluate integrated print- and web-based materials to assist pre-Medicare employees and retirees in choosing a Medicare health plan l Conducted formative research l Developed, cognitively tested and evaluated materials n This presentation will focus on the development and cognitive testing of the materials

5. 5 Theoretical Application n Prochaska and DiClementes Stages of Change Model l People are in 1 of 6 different stages of change l Target audience in a pre-contemplation or contemplation stage l Developed three products to help move target audience to action stage

6. 6 Theoretical Application cont n Bettmans Cognitive Information Processing Model l Limited ability to process information l Kept information concise l Selected content based on what consumers report as most helpful for choosing a health plan l Sensitive to reading level and format style

7. 7 Methods n Materials reviewed by consumer reporting experts n 5 rounds of cognitive testing interviews conducted with 48 employees and retirees l Ages 58 – 64 l In Oregon, North Carolina, and Washington, DC n Materials revised after each round of review and testing

8. 8 Product 1: Bookmark

9. 9 Product 2: Booklet

10. 10 Product 3: Booklet and Interactive Website

11. 11 Principal Findings Mechanics of the Presentation n Liked the idea of receiving bookmark prior to the other products n Preferred photographs of people within their age range n Had difficulty understanding generic descriptions of health plan options

12. 12 Principal Findings (cont) Mechanics of the Presentation n Had difficulty understanding differences in cost n Liked the look and layout of products n Used the worksheet to track factors influencing their decisions n Trusted the information

13. 13 Principal Findings (cont) Plan Choice n Reported that products were easy to use n Understood the quality data n Wanted information about whether their doctor participated in plans

14. 14 Implications for Policy and Practice Mechanics of the Presentation n Remove descriptions of generic plan types n Present only key elements of cost data n Keep information concise and eliminate non-essential details

15. 15 Implications for Policy and Practice Plan Choice n Enable employees and retirees to make a more informed plan choice l Materials reduce complexity of factors to consider and make the decision more manageable l Facilitate use of comparative information