Skip to main content
NCBI home page
Health Services Research logoLink to Health Services Research
. 1992 Dec;27(5):671–693.

The effect of the illness episode approach on Medicare beneficiaries' health insurance decisions.

S Sofaer 1, E Kenney 1, B Davidson 1
PMCID: PMC1069905  PMID: 1464539

Abstract

This article reports on a quasi-experimental test of the Illness Episode Approach (IEA), a new approach to providing Medicare beneficiaries with information about the financial consequences of alternative health care coverage decisions. Beneficiaries were randomly assigned to free, three-hour workshops, half using materials developed through application of the IEA, half using traditional comparative information on insurance options. Analysis of data collected before and after the workshops indicates that participants in the Illness Episode sessions were more likely to drop duplicative coverage, to spend less on premiums, and to report that their decisions to change coverage had met their expectations. The entire sample of workshop participants showed significant increases in knowledge of Medicare and their own insurance, as well as improved satisfaction with the cost of their health care coverage.

Full text

PDF
671

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Acito F. Consumer decision making and health maintenance organizations: a review. Med Care. 1978 Jan;16(1):1–13. doi: 10.1097/00005650-197801000-00001. [DOI] [PubMed] [Google Scholar]
  2. Berki S. E., Ashcraft M. L. HMO enrollment: who joins what and why: a review of the literature. Milbank Mem Fund Q Health Soc. 1980 Fall;58(4):588–632. [PubMed] [Google Scholar]
  3. Cafferata G. L. Knowledge of their health insurance coverage by the elderly. Med Care. 1984 Sep;22(9):835–847. doi: 10.1097/00005650-198409000-00008. [DOI] [PubMed] [Google Scholar]
  4. Davidson B. N. Designing health insurance information for the Medicare beneficiary: a policy synthesis. Health Serv Res. 1988 Dec;23(5):685–720. [PMC free article] [PubMed] [Google Scholar]
  5. Enthoven A. C. Managed competition in health care and the unfinished agenda. Health Care Financ Rev. 1986;(Spec No):105–119. [PMC free article] [PubMed] [Google Scholar]
  6. Garfinkel S. A., Bonito A. J., McLeroy K. R. Socioeconomic factors and Medicare supplemental health insurance. Health Care Financ Rev. 1987 Fall;9(1):21–30. [PMC free article] [PubMed] [Google Scholar]
  7. Grazier K. L., Richardson W. C., Martin D. P., Diehr P. Factors affecting choice of health care plans. Health Serv Res. 1986 Feb;20(6 Pt 1):659–682. [PMC free article] [PubMed] [Google Scholar]
  8. Hibbard J. H., Weeks E. C. Consumerism in health care. Prevalence and predictors. Med Care. 1987 Nov;25(11):1019–1032. doi: 10.1097/00005650-198711000-00001. [DOI] [PubMed] [Google Scholar]
  9. McCall N., Rice T., Sangl J. Consumer knowledge of Medicare and supplemental health insurance benefits. Health Serv Res. 1986 Feb;20(6 Pt 1):633–657. [PMC free article] [PubMed] [Google Scholar]
  10. Mechanic D. Consumer choice among health insurance options. Health Aff (Millwood) 1989 Spring;8(1):138–148. doi: 10.1377/hlthaff.8.1.138. [DOI] [PubMed] [Google Scholar]
  11. Merrill J., Jackson C., Reuter J. Factors that affect the HMO enrollment decision: a tale of two cities. Inquiry. 1985 Winter;22(4):388–395. [PubMed] [Google Scholar]
  12. Sofaer S., Davidson B. N., Goodman R. D., Grier R., Kenney E., Monk N., Ross A. Helping Medicare beneficiaries choose health insurance: the illness episode approach. Gerontologist. 1990 Jun;30(3):308–315. doi: 10.1093/geront/30.3.308. [DOI] [PubMed] [Google Scholar]
  13. Sofaer S., Davidson B. N. Illness-episode approach: costs and benefits of medigap insurance. Health Care Financ Rev. 1990 Summer;11(4):121–131. [PMC free article] [PubMed] [Google Scholar]
  14. Sofaer S., Kenney E. Financial consequences of joining a Medicare HMO: an application of the illness episode approach to estimating out-of-pocket costs. J Health Polit Policy Law. 1989 Fall;14(3):565–585. doi: 10.1215/03616878-14-3-565. [DOI] [PubMed] [Google Scholar]
  15. Varner T., Christy J. Consumer information needs in a competitive health care environment. Health Care Financ Rev. 1986;(Spec No):99–104. [PMC free article] [PubMed] [Google Scholar]
  16. Ward R. A. HMO satisfaction and understanding among recent Medicare enrollees. J Health Soc Behav. 1987 Dec;28(4):401–412. [PubMed] [Google Scholar]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust

RESOURCES