Health plan selection criteria by people with impaired mobility

Med Care. 2002 Sep;40(9):732-42. doi: 10.1097/00005650-200209000-00003.


Background: Many decision-support tools for consumers selecting a health plan include a module measuring peer-group satisfaction with service and quality of care. The most widely used tools are sufficient for most people, but fail to report measures that are important to many individuals with disabilities.

Objectives: To elicit health plan selection and assessment criteria by groups of people with one type of functional impairment arising from different origins.

Research design: Observational study and qualitative analysis of structured focus groups. Content analysis of CAHPS survey instruments.

Subjects: Each participant had a mobility impairment arising from spinal cord injury, cerebral palsy, rheumatoid arthritis, or multiple sclerosis. Each participant had a choice of health plans. Focus groups were conducted in Phoenix, Philadelphia, and Washington DC.

Results: People with mobility impairments arising from the studied conditions desire comparative health plan information on the reliability of transportation to medical appointments, the ability to use an experienced and knowledgeable specialist as a primary provider, and accessible buildings and examination equipment. This study population also seeks information about the experience of their peers in each health plan, especially about benefits administration.

Conclusions: People with mobility impairments arising from spinal cord injury, cerebral palsy, multiple sclerosis, or rheumatoid arthritis currently have little information and little bona fide choice of health plans and physicians. This group of people seeks specific information within the areas of benefit coverage, benefits interpretation and administration, provider panels, accessibility to clinics and equipment, and how to navigate the health plan's grievance and appeals process.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / therapy
  • Cerebral Palsy / therapy
  • Consumer Behavior*
  • Decision Making*
  • Disabled Persons*
  • Female
  • Focus Groups
  • Health Services Accessibility
  • Health Services Needs and Demand
  • Humans
  • Insurance, Health*
  • Male
  • Middle Aged
  • Multiple Sclerosis / therapy
  • Spinal Cord Injuries / therapy
  • United States