The Consumer Health Plan Value Survey: Round Two

Health Affairs

Volumn 16, Issue 4, 1997, Pages 156-166

  Allen Jr , Harris M ^a   Rogers, William H ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONSUMER; COST BENEFIT ANALYSIS; ECONOMICS; EPIDEMIOLOGY; FORECASTING; HEALTH INSURANCE; HEALTH SERVICE; HUMAN; LONGITUDINAL STUDY; QUESTIONNAIRE; STANDARD; STATISTICS; UNITED STATES; UTILIZATION REVIEW;

CONSUMER SATISFACTION; COST-BENEFIT ANALYSIS; FORECASTING; HEALTH BENEFIT PLANS, EMPLOYEE; HEALTH CARE SURVEYS; HEALTH SERVICES NEEDS AND DEMAND; HUMANS; LONGITUDINAL STUDIES; MANAGED CARE PROGRAMS; QUESTIONNAIRES; UNITED STATES;

EID: 0345907712     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.16.4.156     Document Type: Review

References (21)

1. National Committee for Quality Assurance, Health Plan Employer Data and Information Set (HEDIS) 3.0 (Washington: NCQA, 1997). Examples of where the previous version of this survey has recently been administered include Midwest Business Group on Health (Chicago health plans); North Central Texas HEDIS Coalition (Dallas/Fort Worth health plans); Gateway Purchasing Association (St. Louis health plans); and New England HEDIS Coalition (New England health plans). Agency for Health Care Policy Research, Consumer Assessments of Health Plans Study: Call for Public Comment (Rockville, Md.: AHCPR, August 1996).
2. National Committee for Quality Assurance, Health Plan Employer Data and Information Set (HEDIS) 3.0 (Washington: NCQA, 1997). Examples of where the previous version of this survey has recently been administered include Midwest Business Group on Health (Chicago health plans); North Central Texas HEDIS Coalition (Dallas/Fort Worth health plans); Gateway Purchasing Association (St. Louis health plans); and New England HEDIS Coalition (New England health plans). Agency for Health Care Policy Research, Consumer Assessments of Health Plans Study: Call for Public Comment (Rockville, Md.: AHCPR, August 1996).
3. L. Etheredge, S. Jones, and L. Lewin, "What Is Driving Health System Change?" Health Affairs (Winter 1996): 93-104.
4. The problem is comparable to the one that emerged in the recent debate over the Consumer Price Index. See P. Passell, "The Hard Part: Fixing the Errant Price Index," The New York Times, 5 December 1996, C1; F. Stark. "A Technical Ruse," The New York Times, 12 December 1996, A23; P. Krugman, "New Math, Same Story," The New York Times Magazine, 5 January 1997, 32-33; J. Popkin, "Why Play a Numbers Game?" The New York Times, 7 February 1997, A15; and T. Lott, "A Rational Way to Reduce the Deficit," The New York Times, 1 March 1997, 18.
5. The problem is comparable to the one that emerged in the recent debate over the Consumer Price Index. See P. Passell, "The Hard Part: Fixing the Errant Price Index," The New York Times, 5 December 1996, C1; F. Stark. "A Technical Ruse," The New York Times, 12 December 1996, A23; P. Krugman, "New Math, Same Story," The New York Times Magazine, 5 January 1997, 32-33; J. Popkin, "Why Play a Numbers Game?" The New York Times, 7 February 1997, A15; and T. Lott, "A Rational Way to Reduce the Deficit," The New York Times, 1 March 1997, 18.
6. The problem is comparable to the one that emerged in the recent debate over the Consumer Price Index. See P. Passell, "The Hard Part: Fixing the Errant Price Index," The New York Times, 5 December 1996, C1; F. Stark. "A Technical Ruse," The New York Times, 12 December 1996, A23; P. Krugman, "New Math, Same Story," The New York Times Magazine, 5 January 1997, 32-33; J. Popkin, "Why Play a Numbers Game?" The New York Times, 7 February 1997, A15; and T. Lott, "A Rational Way to Reduce the Deficit," The New York Times, 1 March 1997, 18.
7. The problem is comparable to the one that emerged in the recent debate over the Consumer Price Index. See P. Passell, "The Hard Part: Fixing the Errant Price Index," The New York Times, 5 December 1996, C1; F. Stark. "A Technical Ruse," The New York Times, 12 December 1996, A23; P. Krugman, "New Math, Same Story," The New York Times Magazine, 5 January 1997, 32-33; J. Popkin, "Why Play a Numbers Game?" The New York Times, 7 February 1997, A15; and T. Lott, "A Rational Way to Reduce the Deficit," The New York Times, 1 March 1997, 18.
8. The problem is comparable to the one that emerged in the recent debate over the Consumer Price Index. See P. Passell, "The Hard Part: Fixing the Errant Price Index," The New York Times, 5 December 1996, C1; F. Stark. "A Technical Ruse," The New York Times, 12 December 1996, A23; P. Krugman, "New Math, Same Story," The New York Times Magazine, 5 January 1997, 32-33; J. Popkin, "Why Play a Numbers Game?" The New York Times, 7 February 1997, A15; and T. Lott, "A Rational Way to Reduce the Deficit," The New York Times, 1 March 1997, 18.
9. H. Allen Jr., "The Employee Health Care Value Survey," in Collecting Information from Health Care Consumers: A Resource Manual of Tested Questionnaires and Practical Advice (Gaithersburg, Md.: Aspen Publishers, 1996).
10. H. Allen Jr. and W. Rogers, "Consumer Surveys of Health Plan Performance: A Comparison of Content, Approach, and a Look to the Future," Joint Commission Journal for Quality Improvement 22, no. 12 (1996): 775-794.
11. The 1993 survey employed a fifth data-collection step - telephone follow-up. Only respondents obtained by mail from the first four steps are included to parallel the mail-only steps used for the 1995 survey. For a discussion of these techniques, see D. Dillman, Mail and Telephone Surveys: The Total Design Method (New York: John Wiley and Sons, 1978).
12. Our approach is further described in a technical appendix for this work on the Internet at http://ra.ne.mediaone.net/chpvs.
13. Exhibit 2 reports weighted cross-sectional means for the 1993 and 1995 samples. Inferences take into account that the cross-sectional samples share longitudinal members. There is no correction for multiple comparisons.
14. Exhibit 3's 1993 and 1995 means are calculated by sampling group without weighting.
15. Exhibit 4 reports weighted means for the longitudinal sample in 1993 and 1993-1995 changes for this sample, using longitudinal weights.
16. H. Allen Jr. et al., "The Employee Health Care Value Survey: Round One," Health Affairs (Fall 1994): 25-41.
17. Implicit in these results is the position that health status determines satisfaction, not vice versa. This position is supported by the strikingly linear 1993-1995 changes on the PCS and MCS for the values of the self-rated outcomes measure on the 1995 overall sample: For the PCS: poor = -3.00, fair = -2.24, good = -1.34, very good = -0.81, excellent = -0.62. For the MCS: poor = -1.25; fair = -1.18, good = -1.11, very good = -0.67, excellent = -0.47. For further support, see the technical appendix on the Internet.
18. Exhibit 5's means are similar to Exhibit 4's, but they break out results by level of health. Healthy is defined as employees with three or fewer physical chronic conditions in 1993 and values on the PCS and MCS from the SF-12 Health Status survey of 50 or greater. Sick is defined as patients with four or more physical chronic conditions, or PCS ≤ 42, or MCS ≤ 42. Multiple comparisons are not adjusted in Exhibits 4 or 5. For documentation on the statistical package used for these analyses, see Stata Corporation, Stata Statistical Software Reference Manual: Version 5.0, Reference P-Z (College Station, Tex.: Stata Corp., 1997), 135-137. For documentation on variable selection and scoring for the satisfaction and health measures, see H. Allen Jr., Consumer Assessment of Health and Health Care: The Central Iowa Project (Boston: New England Medical Center, 1994); H. Allen Jr., "A Core Set of Survey Items on Health Plan Consumer Satisfaction: A Recommendation to the National Committee for Quality Assurance," in Annual Member Health Care Survey Manual: Version 1.0 (Washington: National Committee for Quality Assurance, 1995); and J. Ware Jr., M. Kosinski, and S. Keller, How to Score the SF-12 Physical and Mental Health Summary Scales (Boston: The Health Institute, 1995).
19. Exhibit 5's means are similar to Exhibit 4's, but they break out results by level of health. Healthy is defined as employees with three or fewer physical chronic conditions in 1993 and values on the PCS and MCS from the SF-12 Health Status survey of 50 or greater. Sick is defined as patients with four or more physical chronic conditions, or PCS ≤ 42, or MCS ≤ 42. Multiple comparisons are not adjusted in Exhibits 4 or 5. For documentation on the statistical package used for these analyses, see Stata Corporation, Stata Statistical Software Reference Manual: Version 5.0, Reference P-Z (College Station, Tex.: Stata Corp., 1997), 135-137. For documentation on variable selection and scoring for the satisfaction and health measures, see H. Allen Jr., Consumer Assessment of Health and Health Care: The Central Iowa Project (Boston: New England Medical Center, 1994); H. Allen Jr., "A Core Set of Survey Items on Health Plan Consumer Satisfaction: A Recommendation to the National Committee for Quality Assurance," in Annual Member Health Care Survey Manual: Version 1.0 (Washington: National Committee for Quality Assurance, 1995); and J. Ware Jr., M. Kosinski, and S. Keller, How to Score the SF-12 Physical and Mental Health Summary Scales (Boston: The Health Institute, 1995).
20. Exhibit 5's means are similar to Exhibit 4's, but they break out results by level of health. Healthy is defined as employees with three or fewer physical chronic conditions in 1993 and values on the PCS and MCS from the SF-12 Health Status survey of 50 or greater. Sick is defined as patients with four or more physical chronic conditions, or PCS ≤ 42, or MCS ≤ 42. Multiple comparisons are not adjusted in Exhibits 4 or 5. For documentation on the statistical package used for these analyses, see Stata Corporation, Stata Statistical Software Reference Manual: Version 5.0, Reference P-Z (College Station, Tex.: Stata Corp., 1997), 135-137. For documentation on variable selection and scoring for the satisfaction and health measures, see H. Allen Jr., Consumer Assessment of Health and Health Care: The Central Iowa Project (Boston: New England Medical Center, 1994); H. Allen Jr., "A Core Set of Survey Items on Health Plan Consumer Satisfaction: A Recommendation to the National Committee for Quality Assurance," in Annual Member Health Care Survey Manual: Version 1.0 (Washington: National Committee for Quality Assurance, 1995); and J. Ware Jr., M. Kosinski, and S. Keller, How to Score the SF-12 Physical and Mental Health Summary Scales (Boston: The Health Institute, 1995).
21. Exhibit 5's means are similar to Exhibit 4's, but they break out results by level of health. Healthy is defined as employees with three or fewer physical chronic conditions in 1993 and values on the PCS and MCS from the SF-12 Health Status survey of 50 or greater. Sick is defined as patients with four or more physical chronic conditions, or PCS ≤ 42, or MCS ≤ 42. Multiple comparisons are not adjusted in Exhibits 4 or 5. For documentation on the statistical package used for these analyses, see Stata Corporation, Stata Statistical Software Reference Manual: Version 5.0, Reference P-Z (College Station, Tex.: Stata Corp., 1997), 135-137. For documentation on variable selection and scoring for the satisfaction and health measures, see H. Allen Jr., Consumer Assessment of Health and Health Care: The Central Iowa Project (Boston: New England Medical Center, 1994); H. Allen Jr., "A Core Set of Survey Items on Health Plan Consumer Satisfaction: A Recommendation to the National Committee for Quality Assurance," in Annual Member Health Care Survey Manual: Version 1.0 (Washington: National Committee for Quality Assurance, 1995); and J. Ware Jr., M. Kosinski, and S. Keller, How to Score the SF-12 Physical and Mental Health Summary Scales (Boston: The Health Institute, 1995).