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Kaiser/Harvard National Survey of Americans’ Views on Managed Care – Toplines/Survey

Kaiser/Harvard National Survey Of Americans’ View On Managed Care

Introduction:

Hello, my name is _________________ and I’m calling for Princeton Survey Research. I’d like to ask a few questions of the Youngest Male age 18 or older, who is now at home. (If No Male At Home Now : Then, may I speak with the Oldest Female age 18 or older who is now at home) (Repeat Introduction If Respondent Did Not Answer The Telephone). We’re conducting an important national opinion survey and would very much like to include your views…

D1.Record Sex

48 Male52 Female100

1. To begin, I’m going to ask how things have been going for you and your family in recent years. Compared to a few years ago, are you and your family better off, worse off, or about the same in this area…? And what about…? (Are you and your family better off in this area, worse off, or about the same?

Better Off worse Off About the Same Don’t Know/ Refused a. Your overall standard of living 41 10 48 1 =100 b. Your ability to save for the future 37 18 43 2 =100 c.Your ability to get good health care 31 14 53 2 =100

2. Now I’m going to read you some terms having to do with health care. As I read each one, please tell me if you know what it means, or if you’ve heard of it, but aren’t sure what it means, or if you never heard of it before this interview. (First,) what about this term…?

Know What It Means Heard of. Not Sure What It Means Never Heard of Don’t Know/Refused a.HMO, or Health Maintenance Organization 62 24 14 *1 =100 b.Medicare 78 20 2 0 =100 c.Managed care 45 26 28 1 =100 d.Primary care doctor 70 17 12 1 =100 e.Medicaid 71 25 4 * =100 f.Gag rules for doctors 25 16 58 1 =100 g.Fee-for-service 41 15 43 1 =100

3. Next, I’d like your opinion of the job some different groups are doing in serving the needs of health care consumers. In answering, please consider everything that might be important to consumers, including quality, cost and convenience.

First, in general, do you think are doing a good job or a bad job in serving health care consumers? Next, do you think… are doing a good job or a bad job ?

Good Job Bad Job Mixed/Neither Good NOr Bad (Vol.) Don’t Know/Refused a.doctors 69 12 16 3 =100 b.Pharmaceutical or drug companies 62 20 11 7 =100 c.HMOs, or Health Maintenance Organizations 36 25 12 27 =100 d.Hospitals 61 18 15 6 =100 e.Health insurance companies 44 32 16 8 =100 f.Nurses 83 4 8 5 =100 g.Managed care health plans 34 21 13 32 =100

4. You said you think HMOs do a (Insert Response From Q.3c– good job/bad job) of serving consumers. What is the Main reason you feel this way? Is it your own experience with an HMO; what you’ve learned from friends and family; or what you’ve seen or heard on television, in newspapers or other media?

Based on all who say HMOs do a good job; n=438

Based on all who say HMOs do a bad job; n=295

Good Job Bad Job 49 42 Own experience 29 32 Friends and family 17 18 TV, newspapers or other media 2 6 Other (Vol.) 3 2 Don’t know/refused 100 100

5. You said you think managed care plans do a of serving consumers. What is the Main reason you feel this way? Is it your own experience with a managed care plan; what you’ve learned from friends and family; or what you’ve seen or heard on television, in newspapers or other media?

Based on all who say managed care plans do a good job; n=402

Based on all who say managed care plans do a bad job; n=264

Good Job Bad Job 35 39 Own experience 32 32 Friends and family 24 22 TV, newspapers or other media 4 4 Other – Volunteered 5 3 Don’t know/refused 100 100

6. Now I’m going to read you another list of some groups in health care. This time, please tell me whether you think of each group more as a business looking out for its bottom line or more as an Organization whose main purpose is to serve people like you. (First,) what about…?

Based on form 1 respondents; n=605

Looking Out for Bottom Line Serving People Like You Don’t Know/Refused a.HMOs and other managed care plans 54 23 23 =100 b.Companies providing traditional health insurance coverage 63 28 9 =100 c.Hospitals 50 39 11 =100 d.doctor’s offices and clinics 38 52 10 =100 e.Pharmacies or drugstOres 48 46 6 =100

7.Now I’m going to read you some characteristics of health insurance plans. As I read each one, please tell me which type of plan you think has this characteristic — Managed Care plans, Traditional health insurance plans, or both types of plans. (First,) which type of plan has this characteristic…

Based on form 1 respondents; n=605

ManagedCare Traditional Health Plans Both -Vol-
Neither Don’t Know/
Refused a. Patients must see their primary care or family doctor first, before they can be referred to another doctor or medical specialist. 53 14 24 1 8 =100 b. Patients must pay additional fees to use doctors or hospitals who are not part of the plan. 50 16 22 1 11 =100 c. Puts more emphasis on preventive care and other health improvement programs. 36 24 24 3 13 =100 d. doctors must follow certain health plan guidelines on the types of treatments and drugs they can give to patients. 47 14 29 1 9 =100 e. Patients must get approval from the health insurance plan before they can receive expensive medical treatment. 48 13 30 1 8 =100 f. Offers a wider range ofbenefits at a lower cost. 39 25 19 4 13 =100 g. Nurses provide much of the routine care that was once handled by doctors 37 16 34 1 12 =100 h. Is more likely to limit payment for certain types of health services when people are sick, in Order to keep costs low 48 16 26 1 9 =100

8. Health insurance plans differ from each other in a number of ways. We’d like to know how different characteristics of a health plan might affect your overall opinion of it. First, if you knew that a health plan had this characteristic… would it make your opinion of the plan more favOrable, less favOrable, or would it not make much difference either way? Next, what if you knew a plan had this characteristic…

Based on form 2 respondents; n=599

more FavOrable Less FavOrable Wouldn’t Make Much Difference Refused Don’t know/refused a. Patients must see their primary care or family doctor first, before they can be referred to another doctor or medical specialist. 36 42 19 3 =100 b. Patients must pay additional fees to use doctors or hospitals who are not part of the plan. 12 68 15 5 =100 c. Puts more emphasis on preventive care and other health improvement programs. 71 8 17 4 =100 d. doctors must follow certain health plan guidelines on the types of treatments and drugs they can give to patients. 34 44 17 15 =100 e. Patients must get approval from the health insurance plan before they can receive expensive medical treatment. 21 58 18 3 =100 f. Offers a wider range of benefits at a lower cost. 80 7 10 3 =100 g. Nurses provide much of the routine care that was once handled by doctors 36 31 30 3 =100 h. Is more likely to limit payment for certain types of health services when people are sick, in Order to keep costs low. 32 48 14 16 =100

Ask All:
9.Are you, yourself, now covered by any form or health insurance or health plan, including Medicare or Medicaid?

10.How long has it been since you last had ANY kind of health insurance coverage?

82 Insured 17 Total uninsured Last Had Coverage 5 Less than a year ago 3 one to two years ago 2 Three to five years ago 5 Five or more years ago 2 Never had coverage * Don’t know when last insured 1 Don’t know if insured 100

11.Based on all your experience with your current health insurance plan, we’d like you to grade the plan’s performance. If A means excellent, B good, C average, D poOr and F failing, what letter grade would you give to your health plan?

Based on all those who are insured; n=991

National 28 A — excellent 43 B — good 19 C — average 6 D — poOr 1 F — failing 2 Not with plan long enough to rate (Vol.) 1 Don’t know/refused 100

11. (Subgroup)Based on all your experience with your current health insurance plan, we’d like you to grade the plan’s performance. If A means excellent, B good, C average, D poOr and F failing, what letter grade would you give to your health plan?

Based on all those who are insured; subgroup n=778

Heavy Light Traditional 20 24 33 A — excellent 44 44 43 B — good 25 20 15 C — average 7 9 4 D — poOr 3 1 0 F — failing * 1 3 Not with plan long enough to rate (Vol.) 1 2 2 Don’t know/refused 100 101 100

for my next question, I want you to think about the Last health insurance plan you had.

12. After I read you a brief description of two different types of health plans, please tell me which type you have today (had in the past) as your Main health coverage…

13. From what you know, is (was) your plan….
Traditional health insurance plans allow you to go to almost any doctor or hospital, but often pay only 80% of the costs of your visit.

Managed Care plans, such as HMOs and PPOs, direct you to a list of doctors and hospitals who are in the plan. If you use doctors or hospitals on the list, the plan pays all or nearly all of the costs. But you have to pay extra if you want to use a doctor or hospital who is not on the list.

To the best of you knowledge, are (were) you covered by…

Based on all who are insured or were insured in the past; n=1163

Based on all who are insured; n=991

Total Now/Past Now Covered 45 44 A traditional health insurance plan, Or 47 50 A managed care plan? 23 23 An HMO, that is, a Health Maintenance Organization 14 16 A PPO, that is, a Preferred Provider Organization, Or 5 5 Some Other type of managed care plan? 5 6 Don’t know which type of managed care 8 6 Don’t know/refused 100 100

Ask All:
14. Now I’d like your views on HMOs and other managed care plans in general, regardless of whether you are personally in managed care. During the past few years, do you think HMOs and other managed care plans have…

a. Made it easier or harder for people who are sick to see medical specialists?

25 Easier 59 Harder 4 No effect (Vol.) 12 Don’t know/refused 100

b1. Increased or decreased the quality of health care for people who are sick?

Based on form 1 respondents; n=605

32 Increased 51 Decreased 7 No effect (Vol.) 10 Don’t know/refused 100

b2. Increased or decreased the quality of health care for patients?

Based on form 2 respondents; n=599

32 Increased 45 Decreased 8 No effect (Vol.) 15 Don’t know/refused 100

c. Made it easier or harder to get preventive services such as immunizations, health screenings, and physical exams?

b2. Increased or decreased the quality of health care for patients?

Based on form 2 respondents; n=599

46 Easier 31 Harder 8 No effect (Vol.) 15 Don’t know/refused 100

d. Helped keep health care costs down, or haven’t made much difference?

28 Helped 55 Haven’t made much difference 5 Made costs go up (Vol.) 12 Don’t know/refused 100

e. Increased or decreased the amount of time doctors spend with their patients?

16 Increased 61 Decreased 9 No effect (Vol.) 14 Don’t know/refused 100

15. As far as you know, do doctors in HMOs and other managed care plans make more money by increasing the amount of services and procedures to patients, or by limiting the amount of services and procedures?

Based on form 1 respondents; n=605

31 Increasing referrals 30 Limiting referrals 3 No difference (Vol.) 16 Don’t know/refused 100

Ask All:
17. Do you think money saved by HMOs and other managed care plans…

Yes No – Vol-Plans Don’t Actually Save Any Money Don’t know/Refused a. Allows employers to pay less forhealth insurance? 56 26 1 17 =100 b. Helps health insurance companiesearn more profits? 72 11 1 16 =100 c. Makes health care more affordable for people like you? 49 38 1 12 =100

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