Comparing in-person versus telephone Medicare counseling: Beneficiary satisfaction, cost-savings, and plan selection decisions from 2014 to 2021

IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Asia White, Nicholas McCormick, Yi Zhao, Kavon Diggs, Salisa C. Westrick, Lindsey Hohmann
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引用次数: 0

Abstract

Background

A pharmacy school and a State Health Insurance Assistance Program developed a Medicare plan selection assistance program in 2013. In 2020, the program changed from in-person to telephone counseling.

Objective

To compare the impact of in-person vs. telephone Medicare counseling on beneficiary satisfaction, cost-savings, and plan selection decisions.

Methods

Outcomes were assessed via anonymous postcounseling survey, including the following: 1) program satisfaction (4-items); 2) annual cost-savings (2-items); and 3) plan selection decisions (1-item). Beneficiary satisfaction was measured using a Likert-type scale (1 = strongly disagree, 5 = strongly agree). Projected cost-savings was calculated as the difference between the total annual drug plus premium costs of the patient's current vs. newly selected plan (actual costs-savings) or least expensive plan option (potential cost-savings) for the next benefit year. Plan selection decision was measured via multiple-choice with response categories of “enrolled in or selected a new plan,” “undecided,” or “stayed with their current plan.” Differences in mean satisfaction scale scores, cost-savings, and plan selection decisions between in-person (2014–2019) and telephone counseling (2020–2021) were analyzed using Mann–Whitney U and Fisher's Exact tests. Predictors of plan selection decision were assessed via logistic regression.

Results

Beneficiaries (N = 632; in-person n = 564; telephone n = 68) were mostly female (59.8%), White (52.1%), and 69 years on average. The overall mean [SD] satisfaction scale score was higher among recipients of in-person (4.55[0.575]) vs. telephone counseling (4.30[0.645]; P = 0.002), but there was no statistically significant difference in mean projected annual cost-savings. Further, in-person vs. telephone counseling recipients more often enrolled in or selected a new plan (46.5% vs. 27.8%; P < 0.05), while telephone vs. in-person recipients were more frequently undecided (37.0% vs. 24.4%; P < 0.05). Overall satisfaction (adjusted odds ratio [aOR] = 11.548; P = 0.009) and potential cost-savings (aOR = 1.001; P = 0.020) predicted selection of a new plan.

Conclusion

In-person counseling resulted in a greater proportion of beneficiaries selecting a new plan whereas telephone counseling resulted in greater decision inertia.
比较面对面与电话医疗保险咨询:2014-2021年受益人满意度、成本节约和计划选择决策。
背景:一所药学院和一个州健康保险援助计划在2013年开发了一个医疗保险计划选择援助计划。2020年,该项目从面对面咨询改为电话咨询。目的:比较面对面与电话医疗保险咨询对受益人满意度、成本节约和计划选择决策的影响。方法:采用匿名心理咨询后问卷调查的方式评估结果,包括:1)项目满意度(4项);2)年成本节约(2项);3)方案选择决策(1项)。受益人满意度采用李克特量表(1=强烈不同意,5=强烈同意)进行测量。预计成本节约是计算患者当前与新选择的计划(实际成本节约)或最便宜的计划选项(潜在成本节约)的年度总药物加上保费成本之间的差额。计划选择决策是通过多项选择来衡量的,回答类别包括“参加或选择一个新计划”、“未决定”或“继续使用他们目前的计划”。使用Mann-Whitney U和Fisher's Exact检验分析面对面咨询(2014-2019)和电话咨询(2020-2021)在平均满意度量表得分、成本节约和计划选择决策方面的差异。通过逻辑回归评估计划选择决策的预测因素。结果:受益人(N=632;面对面n = 564;电话n=68),以女性(59.8%)为主,白人(52.1%),平均年龄69岁。总体平均满意度量表得分(4.55[0.575])高于电话咨询(4.30[0.645]);P =0.002),但在平均预计年度成本节约方面无统计学差异。此外,面对面咨询的接受者比电话咨询的接受者更经常参加或选择新的计划(46.5%比27.8%;结论:面对面咨询导致受益人选择新计划的比例更高,而电话咨询导致更大的决策惯性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.30
自引率
14.30%
发文量
336
审稿时长
46 days
期刊介绍: The Journal of the American Pharmacists Association is the official peer-reviewed journal of the American Pharmacists Association (APhA), providing information on pharmaceutical care, drug therapy, diseases and other health issues, trends in pharmacy practice and therapeutics, informed opinion, and original research. JAPhA publishes original research, reviews, experiences, and opinion articles that link science to contemporary pharmacy practice to improve patient care.
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