Form #9 Form #9 Pretest

C

ID: ___________

AHPS III Reports Team Experimental Research:

Web Pre-Exposure Survey for Consumer Choice Study: Health Plans

1. A health insurance plan provides coverage against medical expenses and often has a group of doctors, hospitals and other health care providers affiliated with it. Have

you ever had to pick a health plan to cover your medical expenses (this would include having chosen among several different plans offered by your employer) ?

□ YES

□ NO

2. Information comparing different doctors, hospitals, or health insurance plans is available in different places. For example, it might be given out at work, come to your home by mail, appear in a newspaper or magazine, or be found on an Internet web site. In the past 12 months, do you remember seeing any information comparing different doctors, hospitals or health plans?

□ YES

□ NO  IF NO, GO TO #6

□ Not sure

3a. Did you see any information comparing quality among different health plans in the past 12 months, or not?

□ YES

□ NO  IF NO, GO TO #4

□ Not sure

3b. If YES, which, if any, of the following specific information comparing quality among different health insurance plans have you seen in the past 12 months? [Check all that apply.]

□ Information from surveys about patients’ experiences with their health plan

From a scientific survey of enrollees in health plans.

□ Ratings of how well doctors in that plan care for people with particular illnesses

From records of the care doctors provide to patients with certain common medical conditions.

□ Written reviews from enrollees about their experiences with their health plan

These reviews are often posted on web sites by enrollees who take the time to provide feedback about their health plan.

□ I have not seen any of these types of information about health plans.

4. Did you see any information comparing quality among different hospitals in the past 12 months, or not?

□ YES

□ NO

□ Not sure

5. Did you see any information comparing quality among different doctors in the past 12 months, or not?

□ YES

□ NO

□ Not sure

6. Based on what you’ve heard, read, or experienced yourself, do you think there are big differences, small differences, or no differences in the quality of care among health plans that offer coverage in your area?

□ Big differences

□ Small differences

□ No differences

□ Not sure

7. Imagine that you needed to choose a new health insurance plan to provide you with your basic medical care. What would you look for in choosing that health plan?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

These last questions are about you and will help us to describe all the people we interview.

8. In general, how would you rate your overall health?

□ Excellent

□ Very good

□ Good

□ Fair

□ Poor

9. In the last 12 months, how many times did you go to a doctor’s office or clinic to get health care for yourself?

□ None

□ 1

□ 2

□ 3

□ 4

□ 5 to 9

□ 10 or more

3

6/1/09 version- Schlesinger