Context-Based Strategies for Engaging Consumers in Using Public Reports

1. Context-Based Strategies for Engaging Consumers in Using Public Reports Dale Shaller Shaller Consulting Group September 20, 2011

2. Overview • The nature of engagement • Why context matters • Examples of choice contexts that can help engage consumers • Implications for public reporting: meeting consumers halfway

3. The nature of engagement Why don’t people pay more attention to the public reports out there today? • Our capacity to make informed choices is limited • Faced with complex choices, people take short cuts to minimize cognitive effort • Most short cuts are driven by emotions, not reason • Emotion-driven decisions often lead people to ignore or overlook important information

4. A new approach: context-based strategies for engaging consumers Why does context matter? • Context affects our motivation to pay attention and learn • Context evokes past experiences that influence what we pay attention to • Context contributes to our emotional states

5. 4 contexts for promoting engagement • Short-term treatment episodes • External disruptions prompting the need to choose a new provider • Serious chronic conditions • Problematic medical experiences

6. Short-term treatment episodes Elective use of services such as joint replacements, cosmetic surgery, and maternity care • Highly “shoppable” services: people can often plan in advance, choose providers • May also face cost-sharing incentives • Targeted promotion of public reports has proven effective in some cases • Example: http://www.calhospitalcompare.orgmaternity campaign

7. Key strategies: Ad content and placement Search words Branded e-mails Promotional event Results: Substantial increase in web traffic Key lessons: Match medium/message to audience Target diverse segments Strategic placement Continuous monitoring CalHospitalCompare Maternity Site:Online Marketing Campaign

8. External disruptions Moving to a new area, changing jobs, changing to a health plan with a different network, etc. • Strong motivation to learn: you have to choose a new provider • Potential for unsettled emotions and anxiety • May have limited time to make a decision • Need for timely, easy-to-use information from a trusted source • Example: State of MN public insurance program http://www.mmb.state.mn.us/insdir/provider_directory.aspx

9. MN Advantage Health Plan Clinic Directory

10. Serious chronic conditions A large and growing segment of the U.S. population: half of all adults have at least one chronic illness • Chronic disease creates a continuing need for monitoring and management • Strong motivation to learn, especially after initial diagnosis • Need to match content of public reports to nature of disease, and combine measures with management information: • MN Community Measurement’s http://www.theD5.org • Wisconsin Health Reports: http://www.wisconsinhealthreports.org • Example: State of MN public insurance program

11. The D5 for Diabetes(Minnesota Community Measurement) URL: http://thed5.org

12. D5 Scores for Stillwater Medical Group

13. Wisconsin Health Reports

14. Problematic medical experiences Almost 8% of Americans report switching doctors each year in response to some problem • High motivation to learn since stakes are high • Emotions run toward fear or anger • Anger may induce information seeking to minimize future risk • Intense fear may lead to information avoidance • Effective engagement may require metrics highlighting negative scores, and help from patient advocates

15. Implications for reporting strategies • Focus on transitional states • Use emotional cues to engage people • Provide content that is relevant to the choice situation • Go beyond ratings to present other useful information • Do the hard work for your audience • Bring all the metrics and care management information together in one place…and simplify! • Target promotion and delivery • Provide help and assistance in using reports!

16. Reference and Acknowledgments “Meeting Consumers Halfway: Context-Driven Strategies for Engaging Consumers to Use Public Reports on Health Care Providers” Dale Shaller, MPA David Kanouse, PhD, RAND Mark Schlesinger, PhD, Yale Paper Commissioned for AHRQ Summit on Public Reporting March 23, 2011