What is the added value of deliberation about priority-setting?
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1 What is the added value of deliberation about priority-setting? Susan Dorr Goold, MD, MHSA, MA Professor of Internal Medicine and Health Management and Policy
2 Acknowledgements Community Co-Director Zachary Rowe, Executive Director, Friends of Parkside Research team: Danis M, Salman C, Szymecko L, Myers CD, Fendrick AM, Kieffer E, Campbell E, Kim H. Steering Committee: Karen Calhoun, Michigan Institute for Clinical and Health Research and City Connect Detroit; Adnan Hammad, Global Health Research, Management and Solutions; Lynnette LaHahnn, AuSable Valley Community Mental Health Authority; Charo Ledón, Acción Buenos Vecinos; Raymond Neff, Spectrum Health; Jennifer Raymond, Mid Michigan Community Action; George Sedlacek, Marquette County YMCA; and Ashley Tuomi, American Indian Health and Family Services. Funding provided by Agency for Healthcare Research and Quality
3 Disclosure Drs. Goold and Danis and their institutions benefit from paid licensed use of CHAT software.
4 Context Medicaid expansion in Michigan Copays for many; premiums for >100% FPL Primary care visit within 3 months Carrots and sticks for Health Risk Assessment, healthy behavior Independent evaluation required by CMS for waiver UM Institute for Healthcare Policy and Innovation Statewide network of community partners and collaborators Goold SD, Rowe Z, Calhoun K, Campbell T, Danis M, Hammad A, Salman C, Szymecko L. The State as Community in Community-based participatory Research. Progress in Community Health Partnerships: Research, Education, and Action (forthcoming Fall 2016)
5 Rationale Setting priorities for the use of limited public resources, particularly for vulnerable citizens enrolled in Medicaid, requires attention to both economics and justice Justice is enhanced by the participation of those most affected by allocation decisions. Engaging current and potential Medicaid enrollees in informed deliberations about Medicaid policy could make the system better reflect the values and needs of the people it serves
6 Aims Engage communities in informed deliberations about Medicaid eligibility, coverage, and cost-sharing. Prepare policy briefs Spending priorities and any differences by subgroup will be communicated to state leaders, community leaders, insurers, and others Examine the impact of public engagement on participants Compare deliberations to education alone. Evaluate representation of perspectives in deliberations
7 Engaging low-income communities in informed deliberations Informed = learn about Medicaid, the ACA, insurance, copays... CHAT exercise - a serious game Pool of limited resources, menu of spending options Different levels of cost sharing, eligibility, community health, health equity and insurance coverage Spin the wheel to see consequences English, Spanish and Arabic
8 Engaging low-income communities in informed deliberations What is Medicaid? Who pays for it? Who is covered? What is the Affordable Care Act? What services are covered? What is Medicaid in Michigan? Sponsored by the Agency for Healthcare Research and Quality (1-R21-HS ) 8
9 سنتحدث اليوم عن: ما هو برنامج ميديكيد له يدفع من من هي الفئات المشمولة في البرنامج هو ما ذو قانون الرعاية الصحية التكلفة المناسبة هي الخدمات ما يغطيها التي ما هو برنامج ميديكيد في والية ميشيغان وكالة ابحاث الرعاية الصحية والجودة ((1-R21-HS
10 CHAT (CHoosing All Together) Sponsored by the Agency for Healthcare Research and Quality (1-R21-HS ) 10
11 برعاية وكالة ابحاث الرعاية الصحية والجودة ((1-R21-HS
12 Design Sample low-income residents Meet in groups of 9-15 Randomized to deliberation or control Control=Educational video about Medicaid, additional resources (links), play CHAT as an individual Deliberation=same+g roup deliberation
13 Data collection Measured at baseline and after education alone or deliberation Knowledge and attitudes about Medicaid Understanding of limited resources Preferences, perceived need for and beliefs about the affordability of health insurance Acceptability of strategies for cost containment, including value-based cost-sharing Medicaid priorities
14 Participant Characteristics N=257 Deliberators N=128 Controls N=129 Female 63.5% 65.1% Mean age (SD, range) 44.5 (15.1, 18-81) 46.6 (14.2, 19-77) Self-identified race White Black/African-American Other, inc. multiracial 55.3% % Hispanic 16.8% 11.7% Arab/Arab-American/Chaldean Education High School/GED or less Some college Bachelor s or more Income < US$15,000 US$ 15,000-34,999 US$35, % % % % Federal Poverty Level 52.6% 64.2% Perceived health status Fair/poor Good Very good/excellent 25.0% %
15 Priorities Selected by Deliberating Groups Category None Level 1 Level 2 Level 3 Deliberation Chronic Conditions - 2 (14.3) 12 (85.7) - Cost Sharing - 4 (28.6) 10 (71.4) - Who is covered? - 1 (7.1) 8 (57.1) 5 (35.7) Connecting to Care 6 (42.9) 4 (28.6) 3 (21.4) 1 (7.1) Emergencies 1 (7.1) 8 (57.1) 5 (35.7) - Meds and Supplies 0 (0.0) 2 (14.3) 12 (85.7) - Mental Health 0 (0.0) 4 (28.6) 8 (57.1) 2 (14.3) Specialty Care 3 (21.4) 5 (35.7) 6 (42.9) - Dental Care 0 (0.0) 7 (50.0) 7 (50.0) - Hospitals 1 (7.1) 10 (71.4) 3 (21.4) - Healthy Communities 7 (50.0) 3 (21.4) 1 (7.1) 3 (21.4) Primary Care 1 (7.1) 8 (57.1) 5 (35.7) 0 (0.0) Home Care 1 (7.1) 7 (50.0) 5 (35.7) 1 (7.1) Hospice 1 (7.1) 7 (50.0) 6 (42.9) - Facility Care 5 (35.7) 9 (64.3) 0 (0.0) 0 (0.0) (E)Quality 5 (35.7) 2 (14.3) 3 (21.4) 7 (28.6)
16 Individual Priorities after Deliberation Category None Level 1 Level 2 Level 3 Chronic Conditions - 37 (29.6) 88 (70.4) - Cost Sharing - 51 (40.8) 74 (59.2) - Who is covered? - 26 (20.6) 70 (55.6) 30 (23.8) Connecting to Care 33 (25.8) 41 (32.8) 29 (23.2) 22 (17.6) Emergencies 13 (10.4) 51 (40.8) 61 (48.8) - Meds and Supplies 9 (7.2) 40 (32.0) 76 (60.8) - Mental Health 11 (8.7) 43 (34.1) 56 (44.4) 16 (12.7) Specialty Care 13 (10.3) 67 (53.2) 40 (31.7) 6 (4.8) Dental Care 6 (4.8) 60 (47.6) 60 (47.6) - Hospitals 12 (9.5) 80 (63.5) 34 (27.0) - Healthy Communities 41 (32.8) 30 (24.0) 27 (21.6) 27 (21.6) Primary Care 10 (7.9) 52 (41.3) 55 (43.7) 9 (7.1) Home Care 14 (11.0) 59 (46.5) 37 (29.1) 17 (13.4) Hospice 13 (10.3) 52 (41.3) 61 (48.4) - Facility Care 34 (27.0) 72 (57.1) 15 (11.9) 5 (4.0) (E)Quality 37 (29.4) 27 (21.4) 34 (27.0) 28 (22.2)
17 Priorities after Education alone Category None Level 1 Level 2 Level 3 Chronic Conditions - 46 (35.9) 82 (64.1) - Cost Sharing - 57 (44.5) 71 (55.5) - Who is covered? - 44 (34.4) 64 (50) 20 (15.6) Connecting to Care 36 (28.1) 40 (31.3) 30 (23.4) 22 (17.2) Emergencies 18 (14.1) 52 (40.6) 58 (45.3) - Meds and Supplies 15 (11.7) 56 (43.8) 57 (44.5) - Mental Health 15 (11.6) 61 (47.3) 41 (31.8) 12 (9.3) Specialty Care 13 (10.1) 65 (50.4) 44 (34.1) 7 (5.4) Dental Care 11 (8.5) 65 (50.4) 53 (40.1) - Hospitals 15 (11.6) 77 (59.7) 37 (28.7) - Healthy Communities 23 (17.8) 37 (28.7) 33 (25.6) 36 (27.9) Primary Care 15 (11.6) 52 (40.3) 48 (37.2) 14 (10.9) Home Care 18 (14.0) 47 (36.4) 50 (38.8) 14 (10.9) Hospice 23 (17.8) 39 (30.2) 67 (51.9) - Facility Care 33 (25.6) 61 (47.3) 25 (19.4) 10 (7.8) (E)Quality 21 (16.3) 47 (36.4) 27 (20.9) 34 (26.4)
18 Individual Priorities after Education Individual Priorities after Deliberation Groups
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20 Knowledge and Understanding (% correct) People are eligible for Medicaid because they have low or moderate incomes Medicaid is paid for entirely by the state Anyone who is eligible for Medicare is eligible for Medicaid People with Medicaid receive prescription medicines for free Only citizens can qualify for Medicaid The federal government sets some rules, but the state government runs the Medicaid program. Deliberators N (%) Controls N (%) p
21 Views of Deliberations The way in which the group reached its decision was equally fair to each member of the group I gained an understanding of arguments that opposed my own My views were considered and taken into account The participants in the group argued by referring to what would be best and most fair for all people All positions in the group were considered with equal respect Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly disagree 45.8% 28.3% 17.5% 5.0% 3.3%
22 Summary Preliminary analyses comparing a simulation exercise-based group deliberation to use of the same exercise by individuals Not much difference in priorities selected deliberators less likely to prioritize healthy communities Not much difference in knowledge Healthy communities and connecting to care were often not selected by groups, while individuals choices spread from no spending to the highest level.
23 Future Directions Compare whether and how priorities changed for deliberators and controls Compare views of the decision and decision making process Examine subgroups (e.g., race, ethnicity, health status) Analyze dialogue, particularly about healthy communities and connecting to care Compare representation of perspectives
24 Implications Need to demonstrate the added value of face-to-face deliberations to justify the time, effort and expense Fair(er) process? Willingness to abide by the decision Better understanding of arguments that oppose their own
25 Questions? Comments? Discussion? Thank you!
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