Understanding Consumer Views on Health Plan Quality in the Marketplace

AIR conducted a study to understand whether existing measures—specifically eValue8™, an evidence-based tool  created by the National Business Coalition on Health (NBCH) to measure and evaluate health plan performance—could meet the needs of consumers shopping for health plans in the Marketplace.  AIR researchers conducted a literature review to identify consumer measures of health plan quality and held four focus groups to test eValue8™ with consumers to determine what information consumers found useful  to evaluate and compare Marketplace plans and develop a subset of measures to assist consumers in selecting plans.Results indicated that consumers care most about out-of-pocket costs and quality measures that reflect their views of health plan responsibilities.

The project also included an environmental scan and expert interviews to develop a report examining which quality and cost measures, as well as rating systems, that the State-based Marketplaces plan to use prior to the implementation of the Quality Reporting System (QRS) to assist consumers in choosing a health plan in the Marketplace.

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