Limits...
Medicaid consumers and informed decisionmaking.

Greene J, Peters E - Health Care Financ Rev (2009)

Bottom Line: In 2006, Florida's Medicaid reform required some Medicaid consumers to enroll in health plans that differed in terms of cost-sharing requirements and benefit limitations.In focus groups we found enthusiasm among Medicaid consumers for having choices among health plans; however, enthusiasm did not translate into comparison shopping for health plans.Given the number of plans offered and the numerous ways they differed, our efforts to simplify the comparison chart resulted in slightly higher comprehension, but only among those with higher skill levels.

View Article: PubMed Central - PubMed

Affiliation: Department of Planning, Public Policy and Management, University of Oregon, Eugene 97405, USA. jessicag@uoregon.edu

ABSTRACT
In 2006, Florida's Medicaid reform required some Medicaid consumers to enroll in health plans that differed in terms of cost-sharing requirements and benefit limitations. In focus groups we found enthusiasm among Medicaid consumers for having choices among health plans; however, enthusiasm did not translate into comparison shopping for health plans. Survey findings suggested that Medicaid consumers had difficulty comprehending Medicaid health-plan comparison information, particularly if they were lower in numeracy or literacy skills. Given the number of plans offered and the numerous ways they differed, our efforts to simplify the comparison chart resulted in slightly higher comprehension, but only among those with higher skill levels. Our study suggests that policymakers should seek to simplify Medicaid Program information and design to encourage informed decisionmaking.

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Revised Medicaid Reform Plan Comparison Chart for Duval County, Florida
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Related In: Results  -  Collection


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f2-hcfr-30-03-025: Revised Medicaid Reform Plan Comparison Chart for Duval County, Florida

Mentions: The other one-half of participants received a version of the plan comparison chart that the authors revised to reduce complexity and increase readability, while at the same time maintaining the differences between plans included in the original chart (Figure 2). We made four key changes, which were based on principles for increasing readability for people with low literacy skills (Doak, Doak, and Root, 1996; Hibbard et al., 2002; Mosenthal and Kirsch, 1998). First, rather than listing all 27 benefit areas, only those areas where there were differences among plans were listed. Second, instead of nesting information on cost-sharing and benefit limitations for each plan in separate columns, cost-sharing information was presented in one row and benefit limitations in another. Third, the plans were arranged from most generous to least generous based on costsharing and extra benefits, rather than alphabetically. Fourth, the font size was increased from size 7 to 10, with labels as large as size 13 font. With these changes, the revised chart was still complex because of the number of plans and areas on which they were assessed. It was assessed as being appropriate for readers with at least a high school degree. To further reduce the complexity, we would have had to abandon our goal of creating a chart that preserved all the differentiating information included in the original chart.


Medicaid consumers and informed decisionmaking.

Greene J, Peters E - Health Care Financ Rev (2009)

Revised Medicaid Reform Plan Comparison Chart for Duval County, Florida
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4195072&req=5

f2-hcfr-30-03-025: Revised Medicaid Reform Plan Comparison Chart for Duval County, Florida
Mentions: The other one-half of participants received a version of the plan comparison chart that the authors revised to reduce complexity and increase readability, while at the same time maintaining the differences between plans included in the original chart (Figure 2). We made four key changes, which were based on principles for increasing readability for people with low literacy skills (Doak, Doak, and Root, 1996; Hibbard et al., 2002; Mosenthal and Kirsch, 1998). First, rather than listing all 27 benefit areas, only those areas where there were differences among plans were listed. Second, instead of nesting information on cost-sharing and benefit limitations for each plan in separate columns, cost-sharing information was presented in one row and benefit limitations in another. Third, the plans were arranged from most generous to least generous based on costsharing and extra benefits, rather than alphabetically. Fourth, the font size was increased from size 7 to 10, with labels as large as size 13 font. With these changes, the revised chart was still complex because of the number of plans and areas on which they were assessed. It was assessed as being appropriate for readers with at least a high school degree. To further reduce the complexity, we would have had to abandon our goal of creating a chart that preserved all the differentiating information included in the original chart.

Bottom Line: In 2006, Florida's Medicaid reform required some Medicaid consumers to enroll in health plans that differed in terms of cost-sharing requirements and benefit limitations.In focus groups we found enthusiasm among Medicaid consumers for having choices among health plans; however, enthusiasm did not translate into comparison shopping for health plans.Given the number of plans offered and the numerous ways they differed, our efforts to simplify the comparison chart resulted in slightly higher comprehension, but only among those with higher skill levels.

View Article: PubMed Central - PubMed

Affiliation: Department of Planning, Public Policy and Management, University of Oregon, Eugene 97405, USA. jessicag@uoregon.edu

ABSTRACT
In 2006, Florida's Medicaid reform required some Medicaid consumers to enroll in health plans that differed in terms of cost-sharing requirements and benefit limitations. In focus groups we found enthusiasm among Medicaid consumers for having choices among health plans; however, enthusiasm did not translate into comparison shopping for health plans. Survey findings suggested that Medicaid consumers had difficulty comprehending Medicaid health-plan comparison information, particularly if they were lower in numeracy or literacy skills. Given the number of plans offered and the numerous ways they differed, our efforts to simplify the comparison chart resulted in slightly higher comprehension, but only among those with higher skill levels. Our study suggests that policymakers should seek to simplify Medicaid Program information and design to encourage informed decisionmaking.

Show MeSH