Identifying Health Maintenance Organization membership through self-report of health plan name: ascertainment and reliability.
OBJECTIVE
To evaluate the feasibility and reliability of (1) identifying Health Maintenance Organization (HMO) membership by ascertaining self-reported health plan name in a telephone survey and (2) using external information to determine whether the plan was an HMO.


METHODS
Respondents to the 1999-2001 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS) and the 1999 Massachusetts Colorectal Cancer (CRC) survey were asked to name their health plan. The authors used information from external sources to classify the plan as an HMO or a non-HMO. Test-retest reliability of reported plan name was examined overall, by demographic characteristics, and by health plan name. Reliability of HMO classification was tested with the kappa statistic.


RESULTS
More than 88 percent of respondents with commercial health insurance provided their health plan name; 84 percent reported a plan that could be assigned as either an HMO or a non-HMO. The percentage whose HMO status could be assigned differed by demographic characteristics. Among those assigned, the distribution of specific HMOs among survey respondents was similar to the distribution reported by the Massachusetts Division of Insurance. In a subsample, 78 percent reported the same health plan during a follow-up interview. Agreement was higher for men, and differed according to the plan reported at the first time point. Kappa for HMO classification from health plan name was 0.87.


CONCLUSIONS
Self-report of health plan name is a feasible and reliable method to ascertain health insurance information in a telephone interview.
Clements
Karen M
KM
Bureau of Family and Community Health, Massachusetts Department of Public Health, Boston, MA 02108, USA. karen.clements@state.ma.us
Cohen
Bruce B
BB
Brawarsky
Phyllis
P
Brooks
Daniel R
DR
Mucci
Lorelei A
LA
Wood
Phillip A
PA
D000293:Adolescent; D000328:Adult; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D012650:Self Disclosure; D011795:Surveys and Questionnaires