Consumer Responses to Health Plan Report Cards in Two Markets

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Abstract
Health plans can compete on quality when consumers have helpful information. Report cards strive to meet this need, but consumer responses have not been measured. The objectives of this study were (1) to compare consumer responses to report cards in 2 markets, (2) to determine how personal characteristics relate to exposure, and (3) to assess the perceived helpfulness of the report cards. A postenrollment survey was used. The study included 784 employees of Monsanto (St Louis, 1996) and 670 employees of a health care purchasing cooperative (Denver, 1997). The dependent measures were (1) exposure, specifically remembering the report card, and intensity of reading it and (2) perceived helpfulness in learning about plan quality and in deciding to stay or switch. Except for remembering seeing the report card (Denver, 47%; St Louis, 55%), the 2 groups did not differ. Forty percent read most or all of the report card; 82% found the report helpful in learning about quality; and 66% found it helpful in deciding to stay or switch. Employees who used patient survey information in their plan decision were more likely to remember seeing the report card (odds ratio [OR], 4.85), to read it intensely (OR, 2.84), and to find it helpful in learning about plan quality (OR, 3.04) and deciding whether to stay or switch plans (OR, 2.64). Although the 2 samples differed markedly, their responses to report cards were similar. Exposure and helpfulness were related more to employee preferences for the type of information than to their health care decision needs.