Enhancing employee capacity to prioritize health insurance benefits.
OBJECTIVE
To demonstrate that employees can gain understanding of the financial constraints involved in designing health insurance benefits.


BACKGROUND
While employees who receive their health insurance through the workplace have much at stake as the cost of health insurance rises, they are not necessarily prepared to constructively participate in prioritizing their health insurance benefits in order to limit cost.


METHODS
Structured group exercises.


METHODS
Employees of 41 public and private organizations in Northern California.


METHODS
Administration of the CHAT (Choosing Healthplans All Together) exercise in which participants engage in deliberation to design health insurance benefits under financial constraints.


METHODS
Change in priorities and attitudes about the need to exercise insurance cost constraints.


RESULTS
Participants (N = 744) became significantly more cognizant of the need to limit insurance benefits for the sake of affordability and capable of prioritizing benefit options. Those agreeing that it is reasonable to limit health insurance coverage given the cost increased from 47% to 72%.


CONCLUSIONS
It is both possible and valuable to involve employees in priority setting regarding health insurance benefits through the use of structured decision tools.
Section on Ethics and Health Policy, National Institutes of Health, Bethesda, MD 20892-1156, USA. mdanis@nih.gov
Marion
M
Danis
Susan Dorr
SD
Goold
Carol
C
Parise
Marjorie
M
Ginsburg
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003256:Community Participation / Q000379:methods*; D003362:Cost-Benefit Analysis; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics / Q000458:organization & administration*; D015276:Health Care Rationing / Q000458:organization & administration; D006292:Health Priorities / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D019458:Insurance Coverage / Q000191:economics / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged