Including the public in healthcare priority-setting faces significant obstacles: apathy, complex information requirements, and emotional barriers to making tradeoffs between competing needs for resources. CHAT (Choosing Healthplans All Together) is a group exercise designed to overcome these obstacles and measure laypersons' preferences and values for health insurance features within the constraint of limited resources. Participants distribute limited resources amongst a wide range of options: degrees of care management, breadth of coverage, restrictions on access and choice, and inclusion/exclusion of some services. Repeated cycles of the game incorporate role-playing to foster an appreciation for the consequences of choices and the perspectives of others. The entire group eventually designs a single healthplan. Group decision making is expertly facilitated to be inclusive, open, deliberative and cooperative. Pre-and post-game questionnaires evaluated participants' experiences. Seventy-eight persons in 6 groups were recruited from outpatient and community settings in North Carolina. They had a mean age of 42.9 (19-66) and were predominantly poor minority men with diverse health and healthcare experience. Study participants found CHAT enjoyable (85.7%), easy to understand (93.4%), easy to do (93.4 %), and informative (90.8%). The majority indicated that they had learned a lot from playing the game (64.5%) and were motivated to learn more about health insurance (71.8%). More than 85% of participants were willing to abide by the group's chosen healthplan. CHAT is an enjoyable, easily understood, informative and motivating exercise which disadvantaged, low income persons without healthcare expertise can use to design healthplans that are cost-conscious and acceptable to them.
Learning Objectives: After participating in this session, attendees will: >Understand the rationale for citizen participation in health care resource allocation and health insurance benefit design >Understand the obstacles to informed choice of health insurance and consumer voice in benefit design/resource allocation >Know the advantages of simulation exercises (games) for policy development
Keywords: Community Planning, Rationing
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None