Purpose of the Study: To find out why individuals choose to engage, disengage, or not to engage in care coordination programs that are meant to improve their health and better navigate the medical care system.
Primary Practice Setting: Care coordination program designed for individuals with an AARP Medicare Supplement Insurance Plan.
Methodology and Sample: A 2-phase study was used involving insureds eligible for disease, depression, or case management programs. The study focused on those who participated in these programs (i.e., the engaged group), those who left the programs after starting their participation (the disengaged group), and those who never engaged in these programs. A telephone survey was conducted first, followed by focus groups and in-depth telephone interviews to address interesting findings from the survey.
Results: The top reasons for program engagement included believing that the program would be helpful (39%), liking its convenience (14%), and because participation was at no additional cost (9%). The top reasons for not engaging included not seeing potential benefit from engagement (28%) and being comfortable with current health care processes (19%). Reasons given for disengaging included lack of time (15%), not believing the program was helpful (13%), not understanding what the program provided (13%), or being unaware of the program (11%). Among the key findings from the focus groups were that individuals who felt they were not getting sufficient support from their medical providers or those needing a sounding board were more likely to engage.
Implications for Case Management Practice: This study provides valuable insight regarding how to best engage individuals with such a plan and who are qualified for care coordination programs. These results suggest that those most motivated to engage are those who are well informed of the program benefits and have a perceived need, such as living alone and needing a sounding board.
Kevin Hawkins, PhD, Vice President, Research and Development, has 20 years of experience conducting and managing health services research. Dr Hawkins has authored more than 100 peer-reviewed articles and presentations and is a reviewer for several journals. Before joining OptumInsight, he worked for IMS-Health, Medstat, and Blue Cross Blue Shield of Michigan.
Timothy S. Wells, PhD, is currently a Senior Health Economics Researcher at OptumInsight. Dr. Wells has more than 25 years' experience leading public health programs and has more than 10 years of experience leading epidemiological studies. Dr. Wells has authored 44 peer-reviewed articles and has served as a reviewer for several journals.
Cynthia E. Hommer, MSW, LICSW, is Account Executive, Payor Solutions, MCG—Formerly Milliman Care Guidelines. Previous to this position, she was the Senior Director of Health Products and Services for United Health Group (UHG) Alliances, in the Health Care Transformation Division. She has 18 years of experience in the health care industry.
Ronald J. Ozminkowski, PhD, Senior Vice President and Chief Scientific Officer at Optum, Consumer Solutions Group. He is recognized as an expert in the evaluation of health and productivity management programs and has published widely on these issues. He holds a doctoral degree from the University of Michigan, with an emphasis in Health Economics.
Diane M. Richards, MBA, Director, Survey Research has more than 20 years of experience leading market research teams and programs designed to better understand the consumer experience and drive new product and brand development. Before joining Optum, she provided market research leadership and support to Ameriprise Financial and General Mills.
Charlotte S. Yeh, MD, FACEP, is the Chief Medical Officer of AARP Services Incorporated where she leads efforts to identify programs that will enhance care for older adults. Previously, she was Regional Administrator for the Boston and New York Regional Offices for the Centers for Medicare & Medicaid Services.
Address correspondence to Timothy S. Wells, PhD, Advanced Analytics, OptumInsight, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108 (Tim.Wells@optum.com).
This work was funded by the Medicare Supplement Health Insurance Program. The investigators retained full independence in the conduct of this research.
Kevin Hawkins, Ronald Ozminkowski and Cindy Hommer have stock options with United Health Group.