Impact of report cards on employees: a natural experiment

D J Knutson, E A Kind, J B Fowles, S Adlis, D J Knutson, E A Kind, J B Fowles, S Adlis

Abstract

To determine the effect of survey-based, health plan report cards on employees as they selected their 1995 health plan, the authors surveyed two groups of Minnesota State employees, one of which received the report card and one that did not. Both groups were surveyed before and after their enrollment. The authors looked for report card effects on relative changes in the employees' knowledge of health plan benefits and their ratings of quality and cost attributes, as well as their plan choice, rates of switching plans, and willingness to pay higher premiums. The only report card effect found was an increase in perceived knowledge for employees with single coverage.

References

    1. Campbell DT, Stanley JC. Experimental and Quasi Experimental Designs for Research. Chicago: Rand McNally College Publishing Company, American Educational Research Association; 1963.
    1. Chernew M, Scanlon DP. Health plan report cards and insurance choice. Inquiry. 1998 Spring;35(1):9–22.
    1. Daniel Yankelovich Group, Inc. Long Term Care in America: Public Attitudes and Possible Solutions, Report of Study Findings. Washington, DC.: Jan, 1990. Prepared for The American Association of Retired Persons.
    1. Dowd B, Feldman R. Premium elasticities of health plan choice. Inquiry. 1994-95 Winter;31(4):438–444.
    1. Eisenberg JM. Health services research in a market-oriented health care system. Health Affairs. 1998 Jan-Feb;17(1):98–108.
    1. Enthoven AC. The history and principles of managed competition. Health Affairs. 1993;12(Supp):24–48.
    1. Federa RD, Oettinger NL. Beyond catastrophic insurance: The future of public funding for long-term care. Topics in Health Care Finance. 1991 Summer;17(4):22–31.
    1. Feldman R, Dowd B. The effectiveness of managed competition in reducing the costs of health insurance. In: Helms RB, editor. Health Policy Reform: Competition and Controls. Washington, DC: The American Enterprise Institute Press; 1993.
    1. Feldman R, Finch M, Dowd B, et al. The demand for employment-based health insurance plans. Journal of Human Resources. 1988 May;24(1):115–142.
    1. Gibbs DA, Sangl JA, Burrus B. Consumer perspectives on information needs for health plan choice. Health Care Financing Review. 1996 Fall;18(1):55–73.
    1. Harvard Community Health Plan, Inc. Annual Report: Keeping score: How does health care measure up? Brookline, MA.: 1993.
    1. Hellinger FJ. Perspectives on Enthoven';s consumer choice health plan. Inquiry. 1982 Fall;19(3):199–210.
    1. Hibbard JH, Jewett JJ. Will quality report cards help consumers? Health Affairs. 1997 May-Jun;16(3):218–228.
    1. Jewett JJ, Hibbard JH. Comprehension of quality care indicators: Differences among privately insured, publicly insured, and uninsured. Health Care Financing Review. 1996 Fall;18(1):75–94.
    1. Knutson DJ, Fowles JB, Finch M, et al. Employer-specific versus community-wide report cards: Is there a difference? Health Care Financing Review. 1996 Fall;18(1):111–125.
    1. Luft HS, Miller RH. Patient selection in a competitive health care system. Health Affairs. 1988 Summer;7(3):97–119.
    1. Marquis MS, Davies AR, Ware JE. Patient satisfaction and change in medical care provider: A longitudinal study. Medical Care. 1983 Aug;21(8):821–829.
    1. McGee J, Hunter M. Employee response to health benefits survey results brochure: Findings from fall 1992 interviews. Dec 28, 1992. Final report to State of Minnesota Department of Employee Relations.
    1. Mechanic D. Consumer choice among health insurance options. Health Affairs. 1989 Spring;8(1):138–148.
    1. Moskowitz DB, editor. Can health plan report cards spur competition on quality? Marketplace, supplement to Medicine and Health. 1997 Jul 7;
    1. O'Connor SJ, Bowers MR. An integrative overview of the quality dimension: Marketing implications for the consumer-oriented health care organization. Medical Care Review. 1990 Summer;47(2):193–219.
    1. Robinson S, Brodie M. Understanding the quality challenge for health consumers: The Kaiser/AHCPR survey. The Joint Commission Journal on Quality Improvement. 1997 May;23(5):239–244.
    1. Rudd J, Glanz K. How individuals use information for health action: Consumer information processing. In: Glanz K, Lewis FM, Rimer BK, editors. Health Behavior and Health Education: Theory, Research, and Practice. San Francisco: Jossey-Bass Publishers; 1990.
    1. Sainfort F, Booske BC. Role of information in consumer selection of health plans. Health Care Financing Review. 1996 Fall;18(1):31–54.
    1. Sofaer S. How will we know if we got it right? Aims, benefits, and risks of consumer information initiatives. The Joint Commission Journal on Quality Improvement. 1997 May;23(5):258–264.
    1. SHW, Inc. Consumers want report cards to tell them how health plans really work, but data is hard to get. State Health Watch. 1996 Sep;3(9):1.
    1. Tumlinson A, Bottigheimer H, Mahoney P, et al. Choosing a health plan: What information will consumers use? Health Affairs. 1997 May-Jun;16(3):229–238.
    1. Ware JE, Snyder MK. Dimensions of patient attitudes regarding doctors and medical care services. Medical Care. 1975 Aug;8(13):669–682.
    1. Wilensky GR, Rossiter LF. Patient self-selection in HMOs. Health Affairs. 1986 Spring;5(1):66–80.

Source: PubMed

3
Subscribe