Early experience with employee choice of consumer-directed health plans and satisfaction with enrollment
Early experience with employee choice of consumer-directed health plans and satisfaction with enrollment
复制标题
DOI：
10.1111/j.1475-6773.2004.00279.x
复制
发表时间：
2004-08-01
影响因子：
3.4
通讯作者：
Bertko, J
中科院分区：
文献类型：
--
作者：
Fowles, JB;Kind, EA;Bertko, J
目标。评估提供消费者定义健康计划（CDHP）选项对员工的初步影响。数据来源/研究设置。2001年6月对Humana公司办公室的4680名员工进行的邮件调查。研究设计。这项研究是对18岁及以上有资格享受医疗保健福利的员工进行的横断面邮件调查。该调查是在公开登记后进行的。主要结果是选择消费者导向的健康计划或不；次要结果是对入学过程的满意度。重要的协变量包括社会人口学特征（年龄、性别、种族、教育水平、豁免或非豁免状态、覆盖类型）、健康状况、医疗保健利用和计划设计偏好。数据收集方法。一份六页的调查问卷被邮寄到每位员工的家中，随后是一张提醒明信片，随后两封邮寄给没有回答的人。主要的发现。回复率为66.2%。7%的人选择了两种新计划中的一种。由于选择两种新方案中的任何一种的员工之间没有显著差异，因此将这些组合并到多变量分析中。逻辑回归模拟了选择新方案的可能性。那些选择新计划的人不太可能是黑人（比值比[OR] 0.46），不太可能只有Humana保险（比值比[OR] 0.30），更可能有单一保险（比值比[OR] 1.77）。他们不太可能有慢性健康问题（OR 0.56），更可能没有最近的医疗访问（OR 3.21）。他们更有可能认为最低保费是最重要的计划属性（OR 2.89），并认为现有计划的保费差异很大（OR 5.19）。健康状况一般或较差的员工在在线注册过程中更有可能遇到困难。他们更有可能发现沟通非常有帮助（OR 0.42），好处信息非常容易理解（OR 0.38）。他们不太可能觉得他们有足够的时间来做出他们的入学决定（OR 0.47）。被新的CDHP计划所吸引的员工重视这些计划与其他选择的区别。然而，向消费者定义的计划和向电子提供信息的转变需要大大增加对所有雇员的通信支持，特别是对那些健康状况一般或较差的雇员，他们的信息需求是最复杂和个性化的。
Objective. To assess the initial impact of offering consumer-defined health plan (CDHP) options on employees.Data Sources/Study Settings. A mail survey of 4,680 employees in the corporate offices of Humana Inc. in June 2001.Study Design. The study was a cross-sectional mail survey of employees aged 18 and older who were eligible for health care benefits. The survey was conducted following open enrollment. The primary outcome is the choice of consumer-directed health plan or not; the secondary outcome is satisfaction with the enrollment process. Important covariates include sociodemographic characteristics (age, gender, race, educational level, exempt or nonexempt status, type of coverage), health status, health care utilization, and plan design preferences.Data Collection Methods. A six-page questionnaire was mailed to the home of each employee, followed by a reminder postcard and two subsequent mailings to nonrespondents.Principal Findings. The response rate was 66.2 percent. Seven percent selected one of the two new plan options. Because there were no meaningful differences between employees choosing either of the two new options, these groups were combined in multivariate analysis. A logistic regression modeled the likelihood of choosing the novel plan options. Those selecting the new plans were less likely to be black (odds ratio [OR] 0.46), less likely to have only Humana coverage (OR 0.30), and more likely to have single coverage (OR 1.77). They were less likely to have a chronic health problem (OR 0.56) and more likely to have had no recent medical visits (OR 3.21). They were more likely to believe that lowest premiums were the most important plan attribute (OR 2.89) and to think there were big differences in the premiums of available plans (OR 5.19). Employees in fair or poor health were more likely to have a difficult time during the online enrollment process. They were more likely to find the communications very helpful (OR 0.42) and the benefits information very understandable (OR 0.38). They were less likely to feel that they had enough time to make their enrollment decision (OR 0.47).Conclusions. Employees who were attracted to the new CDHP plan options valued the attributes that distinguished these plans from other choices. The shift to consumer-defined plans and to the electronic provision of information, however, requires a significant increase in the communication support for all employees, but particularly for those in fair or poor health whose information needs are the most complex and individualized.