Evaluating a Patient-Centered Tool to Help Medicare Beneficiaries Choose Prescription Drug Plans
Condition: Prescription Drug Insurance Decision Making
Study type: Interventional

Summary: 
      The objective of this study is to determine whether providing Medicare beneficiaries with a
      web-based patient-centered decision tool to help them choose among prescription medication
      coverage plans improves outcomes for patients including a greater likelihood of changing a
      plan, better coverage for prescribed drugs, less decisional conflict when choosing plans, and
      greater satisfaction with the choice process relative to current practice.
    

Detailed description: 
      In this study, the investigators tested the effectiveness of two versions of a web-based tool
      (called CHOICE) to help people choose among Medicare Part D plans (Treatments A and B)
      relative to standard care (Control). Both treatment arms incorporated simplified design and
      automated importation of an individual's prescription drugs relative to standard care. The
      treatment arms varied based on whether they provided expert guidance on recommended plans. In
      the control arm, study participants were directed to the existing, publicly available
      Medicare.gov website and received instructions on how to download their drugs from the Palo
      Alto Medical Foundation (PAMF) patient-facing online personal health portal (myhealthonline).
      The study sample included PAMF patients who were enrolled in Part D plans (not Medicare
      Advantage) during the 2016 enrollment period. Prior to the 2017 open enrollment period
      (October 15 to December 7, 2016), we invited a subset of PAMF patients not covered by either
      MediCal or a Medicare Advantage plan, aged 66-85, residing in 4 counties served by PAMF, and
      with at least one active medication order to participate in a study examining the
      effectiveness of decision tools that provide personalized information on the financial
      implications of enrolling in different Part D plans. The primary study outcomes included 1)
      Plan switching, 2) Decisional conflict 3) Satisfaction with the choice process, and 4) Change
      in generosity of coverage of prescription drugs. The investigators measured the primary study
      outcomes using a combination of administrative data and a post open enrollment survey. The
      investigators also collected information on individual characteristics at the time of
      enrollment in the study and implemented a survey examining use of the intervention tool to
      assess patient experience at the time of use.
    

Intervention name(s): Expert Recommendation; Individual Analysis; Usual Care
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Decision support tool that provides personalized information on the financial implications of enrolling in different plans and expert recommendations of particular plans.; Decision support tool that provides personalized information on the financial implications of enrolling in different plans.; Study subjects randomized to the control arm will receive information on how to download their prescription drug information from their electronic medical record and provided with a list of resources available in the community to help them choose a prescription drug plan.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Medicare Part D; decision support; prescription drugs; expert recommendation; health insurance choice