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The Agency for Health Care Policy and Research, now the Agency for Healthcare Research and Quality (AHRQ), initiated the Consumer Assessment of Health Plans Study (CAHPS) project in 1995 to develop and test methods to provide consumers with comparative information on performance of health plans as reported by current health plan enrollees. In collaboration with the Florida Agency for Health Care Administration (AHCA), RAND conducted a CAHPS demonstration with the Florida Medicaid program to test applications of plan performance reports in the Medicaid sector. Both paper and computer-based report formats were designed and tested in field applications in Volusia County, Florida. Evidence was found that failures in any of four dimension of a consumer information strategy can impede consumer use of the information. These dimensions are (1) the types, amounts, and display of the plan performance information itself; (2) design of the report medium, including the paper report document and the software and hardware of the Decision Helper; (3) the physical environment in which the information is provided to potential users; and (4) timing of information availability relative to when plan choices are being made. Both appropriate timing and ease of use of plan performance information influenced whether Florida Medicaid consumers used the reports. For the computer-based system, computer literacy was not a barrier for Medicaid recipients, but attention to details in the system design and physical environment were critically important factors. Results of this work have been applied in subsequent demonstrations with the New Jersey and Iowa Medicaid programs.

Table of Contents

  • Section One

    The Florida Medicaid CAHPS Demonstration

  • Section Two

    Report Designs and Field Applications

  • Section Three

    Evaluation Methods and Data

  • Section Four

    Evaluation Findings for the Paper Report

  • Section Five

    Findings from the Decision Helper Field Test

  • Section Six

    Issues and Policy Implications

  • Appendix A

    Performance Dimensions for Florida Medicaid Plans

  • Appendix B

    Florida Medicaid Booklet

  • Appendix C

    Protocol Materials for Focus Groups with New Enrollees

  • Appendix D

    Alternative Display Formats for Plan Comparisons Tested in Florida Medicaid Focus Groups

  • Appendix E

    Data Collection Form for Observations of Decision Helper Usage in Daytona Beach

  • Appendix F

    Exit Interview Questionnaires for the Decision Helper Field Test in Daytona Beach

  • Appendix G

    Interview Guide for the Process Evaluation

This research was sponsored by RAND's RAND Health.

This report is part of the RAND Corporation Monograph report series. The monograph/report was a product of the RAND Corporation from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

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