title: Employee knowledge of value-based insurance design benefits.
abstract: BACKGROUND
  Value-based insurance designs (VBD) incorporate evidence-based medicine into health benefit design. Consumer knowledge of new VBD benefits is important to assessing their impact on health care use.
  
  
  OBJECTIVE
  To assess knowledge of features of a VBD.
  
  
  METHODS
  The eligible study population was employees receiving healthcare benefits in an integrated care system in the U.S. Pacific Northwest. In 2010, participants completed a web-based survey 2 months after rollout of the plan, including three true/false questions about benefit design features including copays for preventive care visits and chronic disease medications and premium costs. Analysis was completed in 2012. Knowledgeable was defined as correct response to all three questions; self-reported knowledge was also assessed.
  
  
  RESULTS
  A total of 3,463 people completed the survey (response rate=71.7%). The majority of respondents were female (80.1%) Caucasians (79.6%) aged 35-64 years (79.0%), reflecting the overall employee population. A total of 45.7% had at least a 4-year college education, and 69.1% were married. About three quarters of respondents correctly answered each individual question; half (52.1%) of respondents answered all three questions correctly. On multivariate analysis, knowledge was independently associated with female gender (OR=1.80, 95% CI=1.40, 2.31); Caucasian race (OR=1.72, 95% CI=1.28, 2.32); increasing household income (OR for ≥$100,000=1.86, 95% CI=1.29, 2.68); nonunion job status (OR compared to union status=1.63, 95% CI=1.17, 2.26); and high satisfaction with the health plan (OR compared to low satisfaction=1.26; 95% CI=1.00, 1.57).
  
  
  CONCLUSIONS
  Incomplete knowledge of benefits is prevalent in an employee population soon after VBD rollout.
authors.affiliation: Group Health Research Institute, Seattle, Washington. Electronic address: henrikson.n@ghc.org.
authors.forename: Nora B
authors.initials: NB
authors.lastname: Henrikson
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Anderson
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Hubbard
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: Paul
authors.initials: P
authors.lastname: Fishman
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: David C
authors.initials: DC
authors.lastname: Grossman
mesh_terms: D000293:Adolescent; D000328:Adult; D003625:Data Collection; D019033:Delivery of Health Care, Integrated / Q000191:economics; D019317:Evidence-Based Medicine / Q000191:economics*; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015205:Northwestern United States; D062505:Value-Based Purchasing / Q000191:economics*; D055815:Young Adult