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

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

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 3

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 4

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

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: maternity campaignhttp:// 6 Short-term treatment episodes

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

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 External disruptions

MN Advantage Health Plan Clinic Directory 9

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 Wisconsin Health Reports:  Example: State of MN public insurance program 10 Serious chronic conditions

The D5 for Diabetes (Minnesota Community Measurement) URL:

D5 Scores for Stillwater Medical Group 12

Wisconsin Health Reports 13

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 14 Problematic medical experiences

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! 15

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,