Lessons Learned: Actually Asking Consumers What They Think

We all talk about how important the consumer perspective is to any initiative that alters the way health care is delivered or compensated. But how often do we actually reach out to average consumers and find out what they think about our new ideas to reform the system?

We all know what happened to grand plans for managed care.  Managed care sounded great on paper. It realigned provider incentives and successfully reduced the growth of health care expenditures.  But in all the theoretical planning for managed care, no one consulted consumers in any meaningful way.  Consumers hated not being able to choose their own providers and felt that necessary medical care was withheld.  Their backlash was a potent force in managed care’s demise and reduced many consumers’ trust in the health insurance carriers.

Hopefully, lessons have been learned. Trying to be attentive to the consumer experience, CHI recently launched a consumer satisfaction survey of employees of the San Luis Valley Regional Medical Center who are participating in the Engaged Benefit Design pilot project.  This pilot, launched on January 1, 2012 by Engaged Public, couples multiple concepts—financially encouraging consumers (through lower or no cost sharing) to use high value services that are proven to be effective. The pilot discourages participants (through higher cost sharing) from using “preference sensitive” services or those where multiple options for care exist all with different benefits and risks.  In addition, consumers are encouraged to use patient decision aids, tools that provide non-technical explanations of the effectiveness, advantages and disadvantages of various treatment options.

CHI is collecting data on consumer attitudes regarding their 2011 plan design prior to implementation of the pilot.  Over the next two years, CHI will compare that baseline data with how consumers feel after changes to their plan design.

At the end of this two-year pilot, results could show that these interventions mitigate health care cost growth. But costs are only part of the equation.  If such interventions are successfully brought to scale, assessing consumers’ opinions is essential.  Stay tuned for the results.

Note:  The Engaged Benefit Design pilot is being implemented by Engaged Public and sponsored by the AJ Kauvar Foundation.  It is funded by a grant from the Robert Wood Johnson Foundation and the Department of Health Care Policy and Financing’s grant from the federal Health Resources and Services Administration.  CHI is serving as the evaluator of the pilot. 

Amy Downs is a vice president at CHI.